In Argentina, a group of feminist activists, the Socorristas en Red, provide information and accompaniment to people seeking abortions, including beyond 13 weeks gestation. Recently-released WHO guidelines for abortion care acknowledge that abortion trajectories vary and people may seek services and support from a range of settings in the process of an abortion. It follows, therefore, that people who self manage abortions beyond 13 weeks with the support of accompaniment groups may interact with health professionals in the public and/or private sector. Understanding the reasons for and experiences with these interactions can help to inform best practice.

Despite liberalised abortion laws in Colombia and Mexico City, ongoing abortion-related stigma and lack of knowledge of abortion laws can impede access to care. Organisations offering abortion services may support women seeking services by providing counselling and information. We conducted 30 in-depth interviews with women in Colombia and Mexico City after their abortion to understand their feelings of stigma, fears and concerns before accessing services, and how abortion counselling addressed those concerns. Women in both regions cited concerns about abortion safety, fears of judgement from community members and some reported self-judgement or guilt. Before arriving to care, women in Colombia were unsure if they qualified for legal abortion under the current law, and many reported fearing legal or social repercussions for seeking an abortion, whereas women in Mexico knew they could access a legal abortion in Mexico City. Women in all clinics reported satisfaction with the counselling services and felt most of their concerns were addressed. However, most women said they continued to fear judgement from members of the community after their procedure. Service-delivery organisations can provide supportive services and decrease women’s fears and concerns, although interventions in communities are also needed to reduce stigma and improve information.

OBJECTIVE: Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions. This qualitative analysis aimed to understand Socorristas' experiences supporting women who have second-trimester medication abortion outside the formal health care system. STUDY DESIGN: We conducted 2 focus groups with 16 Socorristas in total to understand experiences accompanying women having second-trimester medication abortion who were at 14-24 weeks' gestational age. We performed a thematic analysis of the data and present key themes in this article. RESULTS: The Socorristas strived to ensure that women had the power of choice in every step of their abortion. These cases required more attention and logistical, legal and medical risks than first-trimester care. The Socorristas learned how to help women manage the possibility of these risks and were comfortable providing this support. They understood their work as activism through which they aim to destigmatize abortion and advocate against patriarchal systems denying the right to abortion. CONCLUSION: Socorrista groups have shown that they can provide supportive, women-centered accompaniment during second-trimester medication abortions outside the formal health care system in a setting where abortion access is legally restricted. IMPLICATIONS: Second-trimester self-use of medication abortion outside of the formal health system supported by feminist activist groups could provide an alternative model for second-trimester care worldwide. More research is needed to document the safety and effectiveness of this accompaniment service-provision model.

CONTEXT: U.S. servicewomen have a higher rate of unintended pregnancy than civilian women, yet the military does not provide or cover abortion, except in limited circumstances. Servicewomen's experiences with abortion care have received little research attention. METHODS: Twenty-one in-depth interviews with servicewomen who had had an abortion during active-duty service in the prior two years were conducted between January 2015 and July 2016. Women reported on their experiences accessing abortion, as well as their knowledge and opinions of the military's abortion policy. Data were analyzed thematically using inductive and deductive codes. RESULTS: In regard to their pregnancy and abortion experiences, servicewomen cited concerns about confidentiality, stigma and negative effects on their career, which prevented half of participants from seeking care from the military. Of those who visited a military treatment facility during pregnancy, some reported feeling upset or abandoned by the lack of options counseling and referral. Women reported that the military's abortion policy had negative health and emotional consequences for servicewomen, and negative financial and logistical consequences for both servicewomen and the military. Most did not have accurate knowledge of the abortion policy. Upon learning the law, the majority believed that the military should provide and cover abortion; yet, servicewomen also expressed apprehension about the military's involvement in abortion care, because of concerns about privacy and negative effects on women's careers. CONCLUSIONS: Policy recommendations to better meet the needs of servicewomen include wider dissemination of the military's abortion policy, establishing abortion referral and support guidelines, and improving confidentiality in military health services.

OBJECTIVES: To evaluate the additional burdens experienced by Texas abortion patients whose nearest in-state clinic was one of more than half of facilities providing abortion that had closed after the introduction of House Bill 2 in 2013. METHODS: In mid-2014, we surveyed Texas-resident women seeking abortions in 10 Texas facilities (n = 398), including both Planned Parenthood-affiliated clinics and independent providers that performed more than 1500 abortions in 2013 and provided procedures up to a gestational age of at least 14 weeks from last menstrual period. We compared indicators of burden for women whose nearest clinic in 2013 closed and those whose nearest clinic remained open. RESULTS: For women whose nearest clinic closed (38%), the mean one-way distance traveled was 85 miles, compared with 22 miles for women whose nearest clinic remained open (P ≤ .001). After adjustment, more women whose nearest clinic closed traveled more than 50 miles (44% vs 10%), had out-of-pocket expenses greater than \$100 (32% vs 20%), had a frustrated demand for medication abortion (37% vs 22%), and reported that it was somewhat or very hard to get to the clinic (36% vs 18%; P \textless .05). CONCLUSIONS: Clinic closures after House Bill 2 resulted in significant burdens for women able to obtain care.