• Liza Fuentes, Sharon Lebenkoff, Kari White, Caitlin Gerdts, Kristine Hopkins, Joseph E Potter, and Daniel Grossman.
• Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Ibis Reproductive Health, 1330 Broadway Suite 1100, Oakland, CA, 94612, USA. Electronic address: lfuentes@ibisreproductivehealth.org.
• Contraception. 2016 Apr 1; 93 (4): 292-297.

ObjectiveIn 2013, Texas passed legislation restricting abortion services. Almost half of the state's clinics had closed by April 2014, and there was a 13% decline in abortions in the 6 months after the first portions of the law went into effect, compared to the same period 1 year prior. We aimed to describe women's experiences seeking abortion care shortly after clinics closed and document pregnancy outcomes of women affected by these closures.Study DesignBetween November 2013 and November 2014, we recruited women who sought abortion care at Texas clinics that were no longer providing services. Some participants had appointments scheduled at clinics that stopped offering care when the law went into effect; others called seeking care at clinics that had closed. Texas resident women seeking abortion in Albuquerque, New Mexico, were also recruited.ResultsWe conducted 23 in-depth interviews and performed a thematic analysis. As a result of clinic closures, women experienced confusion about where to go for abortion services, and most reported increased cost and travel time to obtain care. Having to travel farther for care also compromised their privacy. Eight women were delayed more than 1 week, two did not receive care until they were more than 12 weeks pregnant and two did not obtain their desired abortion at all. Five women considered self-inducing the abortion, but none attempted this.ConclusionsThe clinic closures resulted in multiple barriers to care, leading to delayed abortion care for some and preventing others from having the abortion they wanted.ImplicationsThe restrictions on abortion facilities that resulted in the closure of clinics in Texas created significant burdens on women that prevented them from having desired abortions. These laws may also adversely affect public health by moving women who would have had abortions in the first trimester to having second-trimester procedures.Copyright © 2016 Elsevier Inc. All rights reserved.

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