Preferences for abortion access among people living in Texas post-Dobbs: A qualitative exploration of travel decision-making

Since the passage of Texas Senate Bill 8 and the Dobbs decision, Texas residents are navigating new and additional multi-level barriers to abortion care. Many Texas residents are choosing to travel out-of-state for abortion care. As part of a broader mixed-methods project designing a preference solicitation survey, we conducted interviews with individuals living in Texas, recruited via community networks, about their decision-making preferences when considering a hypothetical scenario for traveling for abortion. All interviews were transcribed and coded using reflexive thematic analysis. We inductively developed codes and used a framework of possible codes identified through a systematic literature review. In January-February 2024, our team interviewed 20 individuals living in Texas. We found that to traverse this abortion landscape, people living in Texas would navigate two key travel decision points: 1) whether they should travel out-of-state to access abortion care, and 2) where they should travel out-of-state for abortion care. When navigating these decision points, we found that individuals would consider eleven key attributes: length of time before the appointment, length of time between the appointment and the start of the abortion, length of total travel time for the abortion, number of appointments, length of time away from obligations, mode of transportation, travel route, clinic attributes, cost, method of abortion available, and state protections and restrictions. Increasing state surveillance post- Dobbs , citizenship status concerns, and employment precarity intensified these hypothetical decisions and constrained available choices, underscoring the compounded challenges faced by those who navigate xenophobia, racism, and economic insecurity.