Barriers to accessing second-trimester abortion care: Pre-Dobbs case study from Illinois

This case study of abortion patients in Illinois between 16 to 23 weeks’ gestation provides additional evidence for understanding the challenges of travel and seeking abortion care after the first trimester. Similarly to other studies conducted in the United States before and after Dobbs, we found that respondents faced multiple complex financial and logistical barriers, as well as delays in pregnancy recognition that impeded their access to abortion care.12–16 The vast majority of our sample lived outside of Illinois, and many traveled at least 100 miles to reach the clinic. We found those traveling long distances were more likely to report additional emotional burdens, such as finding the experience to be stressful and tiring.

This case study offers additional evidence useful in assessing current challenges to abortion care; however, there are several limitations to this analysis including that our findings may not be generalizable to the larger population of those seeking second-trimester abortion care outside of the Hope Clinic and that our small study sample prevented us from conducting additional analysis to identify trends in reported barriers across sociodemographic categories such as race, income, and age.

The logistical, financial, and emotional burdens described in our study are likely compounded in the current post-Dobbs landscape. To support more people traveling for care, additional information is needed to assess the challenges and pathways to care when traveling from states where abortion is now illegal or accessible. Specifically, evidence is needed on the impact of abortion bans on a person’s ability to obtain an abortion, how patients procure funds to pay for travel and clinic costs, and how patients manage aspects of travel such as parental consent laws, multiday procedures, and navigating a foreign city. Further research with patients, as well as with staff from abortion funds and practical support organizations, can help to identify opportunities to streamline pathways to care and ensure that patients are able to access timely abortion care.