Barriers to Abortion Access for Young Southerners: A Qualitative Analysis of Case Notes from ARC-Southeast Open Access
Larsen, Ci'erra (Spring 2022)
Abstract
Restrictive abortion laws in Southeastern U.S. states increasingly obstruct access to abortion for young people. Abortion funds have intervened to ensure young people can access safe, compassionate abortion care. Access Reproductive Care-Southeast (ARC-Southeast) is an abortion fund providing financial and logistical support for abortion services in the Southeast. An estimated 1 in 10 of the organization’s cases are people under the age of 22 years. Therefore, analysis of ARC-Southeast's Healthline data offers an opportunity to address a gap in the literature for understanding youth experiences seeking abortion in the Southeast region. We seek to identify barriers and understand youth experiences with abortion fund support for abortion care from ARC-Southeast.
The research team extracted a dataset containing demographic information and case notes managed by ARC-Southeast from cases involving people ages 21 and under who resided in six Southeastern states (Alabama, Florida, Georgia, Mississippi, Tennessee, and South Carolina) and who contacted the Healthline between May 2016 and May 2021 (n=2,278). A qualitative analysis of case notes managed by ARC-Southeast was designed to describe the barriers to access which impede the lives of youth seeking abortion fund support from ARC-Southeast between 2016 and 2021.
The secondary data analysis revealed young Southerners encounter a multitude of barriers to abortion access in the Southeast, within four primary categories: structural barriers, financial barriers, personal barriers, and COVID-19 pandemic. The analysis also exposed common experiences and barriers to abortion access for youth seeking abortion care support which are scarcely documented in abortion access literature, such as the consequences of pre- existing conditions, intimate partner violence, and immigration status. To address these challenges, possible recommendations include engaging young Southerners in a full range of intersectional care and urging legislators in the South to repeal restrictive abortion policy. Study findings inform abortion provision for young people in the U.S. Southeast and serve as a foundation for future research to address barriers to access abortion for young Southerners.
Table of Contents
CHAPTER 1 – INTRODUCTION 1
Introduction and Rationale 1
Problem Statement 3
Purpose Statement 3
Research Objective 3
Significance Statement 4
Definition of Terms 4
CHAPTER 2 – LITERATURE REVIEW 5
Abortion Policy in the United States 5
Supreme Court of the United States Decisions 5
Targeted Regulation of Abortion Providers Laws 7
Trigger Laws 9
Abortion Access in the U.S. Southeast 9
Structural Barriers 9
Socio-Cultural Barriers 14
Young Southerners Access to Abortion 15
Parental Involvement Laws 15
Judicial Bypass 16
Consequences of Abortion Decision 17
The Role of Abortion Funds 19
National Abortion Federation 19
National Network of Abortion Funds 20
Access Reproductive Care – Southeast 21
Reproductive Justice Framework 21
CHAPTER 3 – METHODOLOGY 23
ARC-Southeast Data Collection 23
ARC-Southeast Case Notes 24
Operationalization of Abortion Barriers for Youth 27
Methodological Limitations 29
CHAPTER III – RESULTS 30
1. Structural Barriers 30
1.1. Parental Involvement Laws 31
1.2. Distance Traveled 31
1.3. Gestational Limits 32
1.4. Mandatory Counseling and Waiting Periods 32
1.5. Insurance Coverage 33
1.6. Abortion Fund Resources 33
1.7. Family Planning Provision 35
2. Personal Barriers 36
2.1. Concealment 36
2.2. Parenting 37
2.3. Social Support 38
2.4. Confidants 39
2.5. Anti-Abortion 40
2.6. Pre-existing Health Conditions 40
2.7. Caregiver 41
2.8. Language 41
2.9. Immigration Status 42
2.10. Abortion Type 42
2.11. Violence 43
3. Financial Barriers 44
3.1. Student Status 44
3.2. Employment Opportunity 45
3.3. Rescheduling Appointments 45
3.4. Recurrent and Unexpected Expenses 46
3.5. Homelessness 46
4. COVID-19 Pandemic 47
5. Conceptual Framework: Challenges, Impacts and Opportunities 47
Conceptual Framework 49
CHAPTER 5 – DISCUSSION 50
Implications and Recommendations 54
Dismantle Restrictive Abortion Policy 54
Comprehensive Sexual and Reproductive Health 55
Intersectional Reproductive Health Care Delivery 56
Strengths 56
Limitations 57
Directions for Future Research 59
CHAPTER 6 – CONCLUSION 60
Literature Referenced 61
Appendix 69
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