Barriers to abortion access for young southerners: a qualitative analysis of case notes from ARC-Southeast

Young people in the U.S. Southeast navigate a constellation of legal, systemic and social barriers for abortion care. We identified and described barriers to abortion access experienced by young Southerners who sought abortion funding and the context they navigate to do so. We conducted a secondary qualitative data analysis of case notes from people ages 21 and under who resided in six Southeastern states and contacted ARC-Southeast for support between January 2017 and May 2021 (n = 2,278). Nine-hundred and fifty information rich case notes were selected for thematic analysis. The findings revealed young Southerners encounter a multitude of barriers addressed by abortion funds within four primary categories: structural barriers, financial barriers, personal barriers, and the COVID-19 pandemic. Case notes also described the context that youth seeking abortion care navigate, which are scarcely documented in abortion access literature, such as pre-existing conditions, intimate partner violence, and immigration status. We conceptualized these findings into a framework synthesizing the challenges, impacts, and opportunities for abortion provision in the U.S. Southeast. Each category of barrier contributed to constrained bodily autonomy and delayed abortion care. Abortion funds are uniquely situated among other key actors (e.g., health care providers, legal experts, other advocates, policymakers) and equipped to mitigate barriers that could otherwise deter and delay youth from obtaining abortion care and facilitate young people’s dignity and respect. This research highlights areas where such community-led and youth-centered efforts could be bolstered to address inequities in abortion access and other intersecting health and social systems.