Barriers to medication abortion among Massachusetts public university students

Abstract

Objective: Proposed legislation in Massachusetts would require public university health centers to provide medication abortion services on campus. This study assesses need for these services by investigating current travel time, costs, wait times and insurance acceptance at off-campus, abortion-providing facilities nearest to public universities in Massachusetts.

Study design: This investigation projected the total number of students obtaining medication abortions each year at the 13 Massachusetts public universities based on campus enrollment figures and age- and state-adjusted medication abortion rates. Using a cross-sectional study design, the research calculated the distance and public transit time from campuses to the nearest abortion-providing facilities. Researchers contacted facilities to determine costs, wait times and insurance acceptance.

Results: We estimate 50 to 115 of Massachusetts public university students obtain medication abortion services each month, or 600 to 1,380 each year. Students have to travel between 2 and 42 miles to reach the nearest abortion-providing facility, with a population-weighted average distance of 19 miles each way. Travel time on public transportation to reach the nearest abortion-providing facility takes between 18 and 400 hundred minutes, with a population-weighted average of 103 minutes each way. Average cost of medication abortion was $680, and average wait time to the first available appointment was 8 days. Eight of 13 abortion-providing facilities did not have weekend appointments. All of the nearest abortion-providing facilities in Massachusetts accepted Mass Health, but one nearest facility was out of state and did not. All accepted multiple private insurance plans.

Conclusions: College students face cost, scheduling, and travel barriers to abortion care. Offering medication abortion on campus would reduce these barriers.

Implications: The barriers to medication abortion experienced by students attending public universities in Massachusetts fall particularly hard on female and low-income students, who are disproportionately students of color. Offering medication abortion on campus would reduce these barriers and enhance gender and racial equity on campus.

Keywords: Abortion healthcare; Mifepristone; medication abortion access; public universities; student health centers.