Appalachian residents’ perceptions of abortion issues in their communities prior to the repeal of Roe v Wade

The purpose of this study was to investigate Appalachian residents’ perceptions about abortion access in their communities and to examine the relationship between these perceptions and state-level abortion restrictions, prior to the Dobbs v Jackson court case that repealed Roe v Wade. Residents of the Appalachian region of the United States, between 18 and 49 years of age, were recruited using targeted Facebook advertisements (N = 608). Participants completed an anonymous electronic survey inquiring about perceptions of abortion and accessibility in their communities. Relationships between abortion perceptions, sample characteristics, and state-level abortion restrictions were analyzed. Participants reported that abortion was perceived as unaffordable, geographically inaccessible, of unknown legality, and as occurring uncommonly in their communities. Findings suggest perceptions were informed by religious engagement, shame, and fear of judgment from others. Income, rurality, religious engagement, and hostility of state-level abortion policies were each associated with select abortion perceptions. Results point to opportunities for social workers to engage in abortion policy advocacy and community education in the Appalachian region that would help improve abortion accessibility in regional communities, including those that are rural.