Massachusetts, like the rest of the nation, has experienced an overall decline in abortion providers in both clinics and hospitals in recent years. There are also significant – and growing – regional disparities in access to abortion care, with the majority of providers concentrated in the Metro-Boston area.

Beyond the numbers and geographic distribution, women face other obstacles to obtaining abortion care. The mere presence of a facility providing these services in a given region or community may be insufficient to ensure that women there have access to timely medical services. For instance, the majority of hospital-setting providers only offer abortion care in a very limited set of circumstances (such as for maternal or fetal health conditions).

Lower-income women and those in need of abortion care after the first trimester of pregnancy find their options further restricted. Out-of-pocket costs differ dramatically among providers, with the average hospital charging women over four times as much as the average clinic at the same gestational age.

Many women are forced to delay their care in order to save enough money to pay for their travel and for the procedure itself. National studies document that almost 60% of women who experience a delay cite these factors as contributing to their inability to obtain timely care. This not only affects their health, but further limits their options since most providers do not perform terminations throughout the entire second trimester. Although the vast majority (89%) of abortions occur in the first trimester, women in need of second-trimester procedures are particularly vulnerable due to the higher costs and their sometimes special medical needs.

One important indicator of the future of abortion care is the degree of professional training available in the Commonwealth, which is known for its exceptional medical schools and residency programs. Not all programs offer training in core reproductive health services, including pregnancy terminations. Of those that do, all but one are located in Boston.