Access to Abortion Services in Tennessee: Does Distance Traveled and Geographic Location Influence Return for a Second Appointment as Required by the Mandatory Waiting Period Policy?

The purpose of this article was to examine the average distance traveled to access an abortion procedure, rates of return for the procedure, and whether or not those living in rural zip codes were less likely to return for the abortion compared with residents in urban zip codes, in the context of a 48-hour in-person mandatory waiting period in Tennessee. Findings indicated that over 12 percent of patients who attended the in-person counseling session did not return for the procedure. Moreover, abortion patients in this study traveled an average of 50.53 miles to access abortion care, which is notably higher than the estimated national average of 11.00 miles. Rural residents were significantly more likely than urban residents to have to travel farther to access abortion services. However, neither geographic location nor distance traveled were predictive of returning to the clinic for the second appointment to obtain the abortion, suggesting that patients who did return were able to overcome any geographic disparities. Given the policy mandate that requires a minimum of two in-person clinic visits to obtain the abortion, patients who are traveling farther must still use more resources for two trips, which is a burden to them that is not experienced by more urban residents who are located in closer proximity to abortion providers. The article concludes with a discussion of the implications of the findings for social work practice and policy.