Spatial dimensions of telemedicine and abortion access: a qualitative study of women’s experiences

Reproductive Health

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[1] 0000 0004 0425 469X, grid.8991.9, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK;0000 0004 0425 469X, grid.8991.9, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, WC1E 7HT, London, UK;0000 0001 2297 6811, grid.266102.1, Present address: Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, 1330 Broadway, Ste 1100, 94612, Oakland, CA, USA;

关键词: Abortion;    Telemedicine;    Information visit;    Waiting period;    Spatial theory;   

DOI  :  10.1186/s12978-019-0759-9

来源: publisher

【 摘 要 】

BackgroundTelemedicine may help women comply with onerous legislative requirements for accessing abortion services. In Utah, there are three mandatory steps: a state-mandated information visit, a 72-h waiting period, and finally the abortion procedure itself. We explored women’s experiences of using telemedicine for the first step: the information visit.MethodsWe conducted 20 in-depth interviews with women recruited from Planned Parenthood Association of Utah in 2017 and analyzed them using iterative thematic techniques, using a framework based on Massey’s conceptualization of space as comprising temporal, material and social dimensions.ResultsTemporal, material and social dimensions of women’s access to abortion services intertwined to reduce access and cause discomfort and inconvenience among women in our sample. The 72-h waiting period and travel distance were the key temporal and material barriers, while social dimensions included fear of social judgement, religious influence, and negative stereotyping about people who have abortions. Women described traveling long distances alone and risking excessive pain (e.g. denying pain medication in order to drive immediately after the procedure) to try to overcome these barriers.ConclusionUsing telemedicine helped patients reduce burdens created by policies requiring attendance at multiple appointments in a state with limited abortion services. Attending to spatial aspects of abortion provision helps identify how these different dimensions of abortion access interact to reduce access and impose undue burdens. Telemedicine can improve privacy, reduce travel expenses, and reduce other burdens for women seeking abortion care.

【 授权许可】

CC BY