Medication abortion: State of information on Student Health Center websites

Proximity of Crisis Pregnancy Centers to Colleges and Universities in the United States, 2021

PURPOSE

Since Crisis Pregnancy Centers (CPCs) are known to target college and university (CU) students, the purpose of this analysis was to describe the spatial proximity between CUs and CPCs in the United States by driving distance.

METHODS

Using 2021 data from CPC Map and the US Department of Education's Integrated Postsecondary Education Data System survey, we generated buffer zones around each public and private not-for-profit CU based on driving distance (miles) and examined CPC locations within each buffer. We calculated distances from each CU to the nearest CPC nationally and by state. We then calculated the total number and percentage of female undergraduate students enrolled in CUs with at least one CPC within 3 miles.

RESULTS

A total of 2,546 CPCs and 3,391 CUs were included in the analyses. Nationally, the median driving distance to the nearest CPC was 3.5 miles. In 67% of states, the minimum driving distance to the nearest CPC was less than 0.5 miles. Most (51.5%) undergraduate women were enrolled in a CU with a CPC within 3 miles. Percentages of CUs with at least one CPC within 3 driving miles were highest among private-not-for-profit institutions, CUs with higher student enrollment, doctoral degree conferring CUs, and CUs located in the West South Central and Middle Atlantic subregions.

DISCUSSION

CPCs were located in close proximity to CUs. Efforts to increase awareness about CPCs and their risks and assist students in finding quality sources of care and information may be warranted.

Medication Abortion: Current State and Changing Information on University Student Health Center Websites

BACKGROUND

The reversal of the federal right to abortion through the 2022 US Supreme Court ruling in Dobbs v. Jackson Women's Health Organization is changing the landscape for medication abortion access. Several states with supportive abortion laws are expanding access to medication abortion by mandating that university Student Health Centers (SHCs) provide this service. Meanwhile, other states are limiting even the information that medical providers can give to patients. In this environment, we document changing information on medication abortion on university SHC websites.

METHODS

We conducted thematic content analysis for medication abortion-related information on 549 SHC websites at 4-year bachelor's degree granting public universities/colleges across the United States. We examined information on medication abortion at four timepoints: March 2022, August 2022, February 2023, and February 2024 using computer-assisted software.

RESULTS

Only 1% of the SHC websites detailed information on access to medication abortion in March 2022. By February 2024, 7.5% of SHC websites provided some information on how to access medication abortion. This increase was driven primarily by SHC websites of public colleges in California, New York, and Massachusetts, where legislation required SHC to provide medication abortion services on campuses. For universities that provided any information on medication abortion, the websites had varying details on access and responses to changing state-level legislation and federal regulations.

CONCLUSIONS

Overall, university SHC websites are increasingly mentioning medication abortion, though mostly in states with supportive abortion laws. We anticipate more SHCs will post such information on their websites in response to legal requirements set by state legislatures.

Potential demand for and access to medication abortion among North Carolina college students

OBJECTIVE

To estimate demand for medication abortion (MAB) among North Carolina (NC) college students and describe access to nearest clinics offering MAB to each campus.

METHODS

We calculated demand using 2019-2020 campus demographics and NC abortion statistics. We used a mystery client technique to gather MAB cost and appointment wait times at the closest clinics and calculated travel distances and times.

RESULTS

We estimated that 2,517 NC students seek MAB annually. Twenty-one clinics were closest to NC's 111 colleges and universities, including five in neighboring states. Mean cost was $450, with an average wait time of six days to appointment. The average round-trip travel distance was 58 miles and time to the nearest clinic was 84 min by car.

CONCLUSIONS

Many NC college students likely obtain MAB every year and face high costs, long wait times and distances to care, which has likely worsened after the overturning of Roe v. Wade.

Decreasing reproductive and abortion care barriers: findings on the student health center's role from a student survey

BACKGROUND

College-aged young adults in the US have low utilization and high need for reproductive healthcare. Multiple barriers to reproductive care exist. University Student Health Centers (SHCs) provide varying degrees of reproductive products and services. Recently, California legislated that public university SHCs add medication abortion to their care.

METHODS

To examine existing attitudes and barriers to reproductive healthcare for public university students, we conducted an anonymous online survey at a large, diverse, urban coastal California State University. Students were asked about numerous barriers accessing reproductive services in general and at the SHC, which we categorized into three groups: stigma, access and system. Respondents were also asked about knowledge and preferences for accessing and recommending various services. To understand the extent to which inequities exist, we compared differences across racialized/ethnic identity, gender identity, anticipated degree, and living distance from campus using chi-squared tests.

RESULTS

The majority of survey (n = 273) respondents experienced stigma and access barriers in general healthcare settings which made obtaining reproductive healthcare for themselves or their partners difficult (stigma barriers 55%; 95% CI 49%-61%; access barriers 68%; 95% CI 62-73%). Notably, students reported statistically significant lower rates of access barriers at the SHC, 50%, than in general reproductive healthcare settings, 68%. There were limited differences by student demographics. Students also reported a high willingness to use or recommend the SHC for pregnancy tests (73%; 95% CI 67-78%), emergency contraception pills (72%; 95% CI 66-78%) and medication abortion (60%; 95% CI 54-66%). Students were less likely to know where to access medication abortion compared to other services, suggesting unmet need.

CONCLUSIONS

Our study provides evidence that students face barriers accessing reproductive healthcare and that SHCs are a trusted and accessible source of this care. SHCs have a key role in increasing health, academic and gender equity in the post-Roe era. Attention and financial support must be paid to SHCs to ensure success as state legislatures mandate them to expand reproductive and abortion care access.