Indiana residents already struggled to access abortion care. A post-Roe ban could make it even worse

Abortion is currently legal up to 22 weeks in Indiana, but the procedure requires state-directed counseling, an 18-hour waiting period and is only covered by health insurance in cases of life endangerment, rape or incest.

by Shirin Ali | June 30, 2022 | Jun. 30, 2022

Abortion-rights activist rally at the Indiana Statehouse following Supreme Court’s decision to overturn Roe v. Wade, Saturday, June 25, 2022 in Indianapolis. The U.S. Supreme Court on Friday overturned Roe v. Wade, the 1973 decision that had provided a constitutional right to abortion. The ruling is expected to lead to abortion bans in roughly half the states, although the timing of those laws taking effect varies. AJ Mast/ AP

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The Hoosier Abortion Access Study analyzed how Indiana’s abortion policies impact those in the state who seek out an abortion.

It found cost was the most frequently mentioned barrier, with an abortion procedure costing on average about $562.

One in four participants ended up traveling out-of-state for their abortion, with 70 percent going to neighboring Illinois.

Indiana has some of the most restrictive abortion policies in the country, and a new study outlines exactly how those policies are influencing the lives of women and their families — and it could become even tougher now that the Supreme Court has overturned the constitutional right to abortion.

Currently, abortion is still legal in Indiana until 22 weeks after the last menstrual period, but patients must go through state-directed counseling and wait 18 hours before the procedure can be done. Health insurance plans in the state will only cover the procedure in cases of life endangerment, rape or incest.

Medication abortion is also banned after 10 weeks of pregnancy and cannot be administered through telemedicine either.

Those barriers have likely contributed to Indiana’s low abortion rate; in 2019 there were about 5.8 abortions per 1,000 Indiana residents among women aged 15 to 44 years old.

That’s only half of the national abortion rate and substantially lower than other Midwestern states.

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However, that’s something researchers at Indiana University and Ibis Reproductive Health don’t want attributed to a fewer number of unintended pregnancies — they found 49 percent of pregnancies in Indiana are considered unintended while the national rate is 45 percent.

Through the Hoosier Abortion Access Study, which looked at nearly 500 Indiana residents between June 2021 and May 2022, researchers found getting an abortion is a burdensome process in Indiana.

“What we heard and what we saw in the study are the incredible barriers that had to be overcome to access abortion,” said Tracey Wilkinson, assistant professor of pediatrics at Indiana University School of Medicine and co-investigator of the study, who spoke to local media about the new study.

“People were saying the cost was making them have to choose between feeding their family, paying bills, or rent.”

Wilkinson’s team found that the average cost of an abortion in Indiana is $562 — and that cost was one of the most frequently mentioned barriers to accessing abortion care.

Because of that cost, 10 percent of participants decided to self-manage their abortion — herbs and medication abortion being the most common options mentioned.

Eighty-three percent of participants who did receive their abortion said the price they paid affected their ability to pay rent and bills, buy food or pay for childcare.

In a one-month follow-up, nearly one in four participants, about 24 percent, still hadn’t gotten their wanted abortion. Many were still trying to find an abortion provider, had miscarried, given birth or resolved to give birth.

Notably, researchers found 1 in 4 participants ended up traveling out-of-state to get their wanted abortion, citing that it was cheaper and/or they were able to get financial assistance from an out-of-state clinic.

About 70 percent of the study’s participants went to Illinois for their abortion — a state that has been preparing for an influx of tens of thousands of new patients now that the Supreme Court has overturned Roe v. Wade.

Abortion access could become further restricted in Indiana after Gov. Eric Holcomb (R) and other top Republican lawmakers have pledged to address abortion during a special legislative session that is scheduled to begin July 6.

Many states have already enacted abortion restrictions or bans, including Missouri, Kentucky, Ohio, Arkansas and more.

That worries Wilkinson who noted that, in addition to the health risks, state abortion bans could influence the health care workforce, with healthcare workers choosing to practice in states that don’t penalize the procedure or even medical residents choosing to study in states that won’t put limits on their training.

“I know that a few years down the road they’ll be like ‘we didn’t know that was going to happen,” said Wilkinson. “I just want to have in print that I said it… we said that women were going to die, that people weren’t going to come here to train. We said it and you didn’t listen.”