It is critical to conduct research with people who consider abortion but never connect with a clinic, whose stories may help identify the largest impediments to abortion access. The need for this evidence is urgent in post- Dobbs restrictive states, including Wisconsin. We 1) located abortion considerers through innovative recruitment mechanisms, 2) examined their experiences within a dynamic state-based context, and 3) adapted a brakes-and-accelerators model to document the factors that most impede abortion-seeking trajectories, including those most amenable to intervention. Using three recruitment arms, we enrolled pregnant Wisconsinites who had considered abortion between June 2022 and February 2025: 1) callers to abortion clinics, 2) prenatal patients, and 3) people seeking abortion information online. Participants completed in-depth interviews about abortion consideration. We analyzed interview data using a qualitative descriptive approach. Forty-two interviewees ( n =8 clinics callers, 30 prenatal patients, 4 online information seekers) described over 20 brakes and accelerators to abortion, from legal (e.g., Wisconsin’s telehealth ban) to logistical (lack of transportation), personal (pregnancy ambivalence) to relational (interpersonal violence), cultural (stigma) to structural (housing insecurity). Three intervenable factors emerged as critical to abortion access (or lack thereof): 1) finances and insurance coverage, 2) state abortion restrictions, and 3) patient navigation services and resources. Our study would have underestimated these factors’ impact had we only recruited from abortion clinics. The brakes-and-accelerators model enables a clearer vision of how factors work in tandem to propel, or impede, individuals toward different pregnancy outcomes. • Research can overlook people who consider abortion but never get to a clinic. • It’s possible to recruit abortion-considerers through alternative venues. • Many brakes and accelerators affect pregnancy trajectories, including abortion. • The biggest brakes/accelerators in one state were laws, money, and care navigation. • Policy makers, public health professionals, and advocates could address these factors to ensure abortion access and reproductive autonomy and equity.
Higgins et al. (Sun,) studied this question.