Geographic Access to Crisis Pregnancy Centers and Abortion Facilities by State Abortion Policy.

Abstract

Since the US Supreme Court's Dobbs v Jackson Women's Health Organization decision, the number of abortion facilities has decreased; meanwhile, government funding for and the number of crisis pregnancy centers (CPCs), Christian nonprofit organizations that aim to divert people from having abortions, has increased. To examine geographic access to CPCs and abortion facilities in the US, accounting for state abortion policies. This cross-sectional study used 2023-2024 data from CPC Map, an online geocoded CPC directory, and 2023 data from Advancing New Standards in Reproductive Health's Abortion Facility Database to map 4 types of zones based on proximity to CPCs and abortion facilities in the contiguous US, estimate the number of women of reproductive age (15-49 years) who lived in each zone, and calculate driving distances from census block group centroids to the nearest CPC and abortion facility in 2023. Geographic zones within 15-mile radii of CPCs and of abortion facilities where abortion was legal at 9 weeks' gestation and each census block group centroid's distance from the nearest CPC and abortion facility if seeking services at 9 or 19 weeks' gestation, based on abortion bans and restrictions effective December 31, 2023. Census block groups in each of 4 zones (neither a CPC nor an abortion facility, a CPC facility only, an abortion facility only, or both a CPC and an abortion facility within a 15-mile radius) and the number of reproductive-aged women who lived in each zone, along with driving distance to the nearest CPC and abortion facility, given state abortion policies. The study included 74 592 177 reproductive-aged women in 237 818 US census block groups. Less than half of block groups (46.5%) and of women (49.5%) were located within 15 miles of both a CPC and an abortion facility, over one-third (36.1% of block groups and 37.3% of women) were within 15 miles of a CPC only, 16.7% of block groups and 12.6% of women were more than 15 miles from both a CPC and an abortion facility, and 0.7% of both block groups and women were within 15 miles of an abortion facility only. Nationally, the median driving distance to the nearest CPC was 5.52 miles (range, 0.00-242.80 miles). The median distance to the nearest abortion facility was 17.17 miles (range, 0.01-711.73 miles) for people seeking abortion care at 9 weeks' gestation and 29.73 miles (range, 0.01-1012.28 miles) for those seeking care at 19 weeks' gestation, with substantial variation by region (particularly in the South) and state. This cross-sectional study examining the comparative geographic access to CPCs and abortion facilities throughout the US found CPCs' dominance was nearly uniform and variations in geographic access to abortion facilities based on residence and gestational duration were considerable. The findings suggest health professionals should educate patients and the public about CPCs and how to identify them and should advocate for policies that promote health and access to quality health care.