title: Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Law in Texas.
abstract: OBJECTIVE
  To evaluate the additional burdens experienced by Texas abortion patients whose nearest in-state clinic was one of more than half of facilities providing abortion that had closed after the introduction of House Bill 2 in 2013.
  
  
  METHODS
  In mid-2014, we surveyed Texas-resident women seeking abortions in 10 Texas facilities (n = 398), including both Planned Parenthood-affiliated clinics and independent providers that performed more than 1500 abortions in 2013 and provided procedures up to a gestational age of at least 14 weeks from last menstrual period. We compared indicators of burden for women whose nearest clinic in 2013 closed and those whose nearest clinic remained open.
  
  
  RESULTS
  For women whose nearest clinic closed (38%), the mean one-way distance traveled was 85 miles, compared with 22 miles for women whose nearest clinic remained open (P ≤ .001). After adjustment, more women whose nearest clinic closed traveled more than 50 miles (44% vs 10%), had out-of-pocket expenses greater than $100 (32% vs 20%), had a frustrated demand for medication abortion (37% vs 22%), and reported that it was somewhat or very hard to get to the clinic (36% vs 18%; P < .05).
  
  
  CONCLUSIONS
  Clinic closures after House Bill 2 resulted in significant burdens for women able to obtain care.
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gerdts
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Liza
authors.initials: L
authors.lastname: Fuentes
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Kari
authors.initials: K
authors.lastname: White
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Brianna
authors.initials: B
authors.lastname: Keefe-Oates
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Baum
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Kristine
authors.initials: K
authors.lastname: Hopkins
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Chandler W
authors.initials: CW
authors.lastname: Stolp
authors.affiliation: Caitlin Gerdts, Liza Fuentes, Sarah E. Baum, and Brianna Keefe-Oates are with Ibis Reproductive Health, Oakland, CA. Daniel Grossman is with the University of California, San Francisco. Kari White is with the University of Alabama, Birmingham. Kristine Hopkins, Chandler W. Stolp, and Joseph E. Potter are with the University of Texas at Austin.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Potter
mesh_terms: D000028:Abortion, Induced / Q000331:legislation & jurisprudence*; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D005865:Gestational Age; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D012959:Socioeconomic Factors; D013781:Texas; D014195:Travel / Q000706:statistics & numerical data*; D055815:Young Adult