Understanding Trust, Delays and Black Women's Experiences Obtaining Abortion Care in the <scp>US</scp> Midwest

INTRODUCTION: Abortion scholars treat the timing of care as an important measure of access. Despite the legacy of medical mistreatment of Black people, few studies have explored the racialized relationship between medical trust and when abortion care is obtained. We examined how differences in healthcare provider trust impact the timing of receiving abortion care. METHODS: In 2020-2021, we invited people seeking abortion care in West Virginia, Kentucky, and Ohio to complete an electronic survey. We assessed the prevalence of general healthcare provider trust and abortion provider trust and examined associations among race, trust, and timing of obtaining abortion care. RESULTS: Respondents who reported that they did not trust the last healthcare provider they saw for an issue other than the abortion (8% of respondents) were more likely to have a second trimester abortion (odds ratio (OR): 1.74, 95% confidence interval (CI): 1.00-3.06). This association was stronger for Black respondents (OR: 2.63, 95% CI: 1.27-5.47). Not trusting the abortion provider was uncommon (1% of respondents) and was not significantly associated with the timing of obtaining abortion care (OR: 1.24, 95% CI: 0.28-5.42). CONCLUSIONS: Not trusting the last healthcare provider was associated with receiving abortion care later than those who did trust their last provider. More research is needed to fully understand the nuanced relationship between race, trust, and delays in abortion care.