Understanding the complexities of access, and how to improve it, is AAP’s daily challenge. In conjunction with the recent launch of Least Access States Initiative, AAP partnered with a research organization, Ibis Reproductive Health, to take a detailed look at abortion access in twelve possible project states.

Dr. Courtney Jackson, lead researcher on the project and AAP’s newly appointed Director of Research and Evaluation describes taking on such a project: “Understanding abortion access goes far beyond looking at legislation and mapping out in which counties we find the few abortion providers. It’s also about poverty and immigration status of women, the availability of training and fervor of anti-abortion activities, just to name a few.”

In addition to breaking down state’s restricted abortion access, the new research examined opportunity for improvement.

Says Jackson, “In some of these states, there are energized allies or well-developed health infrastructures to potentially engage. Picking up the phone and talking with a particularly enthusiastic doctor, ready to throw weight behind the goals of the project, reinforces that there is potential out there, even in states with the most restricted access to services.”

 Key findings include:

Mississippi, Arkansas, and West Virginia as those states with the least access to abortion care, factoring information on contraceptive availability and use, women’s access to healthcare and insurance, and general information on the health of the state population. In contrast, Missouri, Utah and South Carolina were identified as those states presenting the greatest opportunity out of the twelve examined. Opportunity is assessed by potential partners (pro-choice and allied organizations), existing health infrastructure, as well as the number of women in the state that improvements to abortion access could impact.

The Least Access States Initiative research offers a new way to think about abortion access by considering it in combination with opportunity.  Additionally, by methodically collecting and combining information on women’s lives, the medical and healthcare community, and the political and regulatory environment, it capture abortion access for what we know it to be – an intersection of systematic barriers to women’s health and autonomy. Notes Courtney, “This frame has use beyond the AAP’s Least Access States Initiative. A nuanced understanding of access has the potential to inform and assist the broader movement around reproductive rights and health.”

Research is a good start, but only the beginning for AAP’s new project. The Least Access State Initiative will be following up with outreach to state and community groups and on-the-ground organizing. Our goal is to work with people in project states to better understand the issue of abortion access and identify and implement strategies that will make a meaningful difference for the women who live there.

“There needs to be different thinking and organizing about reproductive rights and abortion care, especially in states with many obstacles to success”, says LASI Project Director Dr. Mary Ann Castle. “This research is a first step toward generating broad discussion about abortion within the context of what is most important to women in these states."

Castle continues, "My hope is to work with reproductive health and rights agencies as well as with partners who may be new to this issue, such as, HIV prevention/care and domestic violence organizations, health committees of labor unions, single payer health insurance advocates, religious groups, immigrant health and other grass roots organizations representing and serving a clients form a diversity of class, ethnic/racial and cultural backgrounds. My experience has shown me that successful solutions to local problems are best built on partnerships between diverse constituencies working to create synergies for mutual benefit."