Evaluating abortion cash-pay availability during the early covid-19 pandemic: Data from a nationwide survey of abortion providers

ABSTRACT

Pregnant people seeking abortion may require access to cash-pay services, and little is known about cash-pay availability for abortion services among US abortion clinics. We examined differences in cash-pay options between hospital-affiliated clinics and non-hospital-affiliated clinics (independent or Planned Parenthood clinics). We analyzed data from the second phase of a longitudinal nationwide survey of abortion providers conducted by the Society of Family Planning (collected May–July 2020). We compared cash-pay options for medication abortion, first-trimester surgical/procedural abortion, and dilation and evacuation offered by hospital-affiliated and non-hospital-affiliated clinics. Sixty-two clinics completed the survey (31 hospital-affiliated and 31 non-hospital-affiliated). We found that 85% of all clinics offered a cash-pay option for medication abortion, 86% for first-trimester abortion, and 78% for dilation and evacuation. We found that hospital-affiliated clinics were significantly less likely to report serving out-of-state patients (p<0.01), first-trimester surgical/procedural abortion (75% vs. 97%, p=0.02), and dilation and evacuation (62% vs. 100%, p<0.01). Though a majority of all clinics surveyed offered cash-pay options for abortion, hospital-affiliated clinics were less likely to offer cash-pay options for abortion procedures. Given concerns regarding future abortion access, it will be important to expand availability of cash-pay options for abortion in all settings. From our data, hospital-affiliated clinics have the most room to improve on this front. [ FROM AUTHOR]