Access to abortion care has become increasingly complex in the aftermath of shifting political decisions and mounting restrictions across the United States. With last week’s transition in Washington DC, federal-level abortion access is back in the national spotlight.
The landscape of abortion care has undergone a significant transformation since 2022, with medication abortion emerging as a dominant method of care. In the pre-Dobbs decision landscape, in-clinic procedures were the standard for most individuals seeking abortion care. However, in the wake of increasing legal and logistical barriers like clinic shutdowns, there has been a marked shift toward self-managed medication abortion. In early pregnancy, medication abortion is a safe, effective, and often more accessible option that allows people greater privacy and control over the process.
Over the past 3 years, The Wallace Center and Bixby Center collaborated with UNC-Chapel Hill postdoc and recent DrPh graduate Betsy Pleasants on research using data from the social networking platform Reddit (the subreddit r/abortion) to better understand people’s real-life experiences of accessing abortion care since Roe v.Wade was overturned. Findings from the r/abortion study reveal gaps in abortion information, support, and access. As the future of abortion access remains unclear in this uncertain political climate, the r/abortion study serves as a foundation for understanding these shifts and emphasizes the ongoing need for further studies into this critical aspect of reproductive healthcare.
“Is This Normal?”: A Qualitative Exploration of Narratives of Social Support in a Reddit-Based Community for Abortion Following the Dobbs Leak in 2022 highlights how social support may significantly influence both access to and experiences with abortion. Findings illustrate the role of community (in this case the online community r/abortion) as a crucial resource for seeking guidance, sharing experiences, and reducing isolation, emphasizing the importance of online spaces for stigmatized health needs and during periods of uncertainty.
“Abortion access barriers shared in “r/abortion” after Roe: a qualitative analysis of a Reddit community post-Dobbs decision leak in 2022,” examines barriers to abortion access in r/abortion. This analysis showed that structural barriers like state abortion bans, high costs, travel burdens, and appointment delays were common, alongside social barriers such as stigma, lack of support, and legal fears. Emerging challenges included delays with mail-ordered medications and concerns about online platforms. These barriers often led to mental health struggles, delayed care, and reliance on self-managed abortions out of necessity, not choice.
As reliance on self-managed medication abortion grows amid diminishing clinic access, shield laws play a key role in protecting clinicians and ensuring that individuals, regardless of their state laws, can still receive medication abortion care by mail. The Shield Laws for Reproductive and Gender-Affirming Health Care: A State Law Guide offers a comprehensive analysis of each state's shield laws. Additionally, You Always Have Options serves as a vital resource for individuals seeking safe abortion care in states where access is restricted.
In some states, restrictions on both mailing abortion pills and clinical care exacerbate barriers to access, forcing individuals to travel across state lines to secure care. This has led to an influx of patients into states where abortion remains legal and accessible, causing increased waits for abortion based on lack of appointment availability. The increase in wait times for in-clinic procedures has led to new gaps in care and education on how people can support themselves while waiting for abortion care. Read more in Insights from r/abortion show people wait weeks for an abortion in the US
As much as abortion care policy is in flux right now, several core things remain true: medication abortion is safe and effective, abortion care is an integral part of healthcare, and 79% of Americans oppose a federal abortion ban according to a Memo on Public Opinion on Abortion in 2025 from The COMS Project. Data from the r/abortion study similarly highlight that community, access to information and social support deeply impact people's experience throughout the abortion process and are vital to a public health response.
Check out the Wallace Center website for more information on r/abortion and ongoing research projects. For more information about this research, contact the Wallace Center for MCAH Research (wallacecenter@berkeley.edu).