Objectives: States vary significantly in their regulation of abortion. Misinformation about abortion is pervasive and propagated by state-mandated scripts that contain abortion myths. We sought to investigate women's knowledge of abortion laws in their state. Our secondary objective was to describe women's ability to discern myths about abortion from facts about abortion. Study design: This was a cross-sectional study of English-and Spanish-speaking women aged 18-49 in the United States. We enrolled members of the GfK KnowledgePanel, a probability-based, nationallyrepresentative online sample. Our primary outcome was the proportion of correct answers to 12 questions about laws regulating abortion in a respondent's state. We asked five questions about common abortion myths. We used descriptive statistics to characterize performance on these measures and bivariate and multivariate modeling to identify risk factors for poor knowledge of state abortion laws. Results: Of 2223 women contacted, 1057 (48%) completed the survey. The mean proportion of correct answers to 12 law questions was 18% (95% CI 17-20%). For three of five assessed myths, women endorsed myths about abortion over facts. Those who believe abortion should be illegal (aOR 2.18, CI 1.40-3.37), and those living in states with neutral or hostile state policies toward abortion (neutral aOR 1.99, CI 1.34-2.97; hostile aOR 1.6, CI 1.07-2.36) were at increased odds of poor law knowledge. Conclusions: Women had low levels of knowledge about state abortion laws and commonly endorse abortion myths. Women's knowledge of their state's abortion laws was associated with personal views about abortion and their state policy environment. Implications: Supporters of reproductive rights can use these results to show policy makers that their constituents are unlikely to know about laws being passed that may profoundly affect them. These findings underscore the potential benefit in correcting widely-held, medically-inaccurate beliefs about abortion so opinions about laws can be based on fact.

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Background North Carolina enacted 5 statutes restricting abortion between 2011 and 2016. Our objective was to compare the proportion of women who traveled more than 25 miles to a Southern tertiary care center during 2 distinct time periods (2011 and 2017). Methods We conducted a time-series retrospective cohort study of women who obtained an abortion at University of North Carolina hos­pitals in 2011 and 2017. We collected data regarding residence, demographics, gestational age, indication, parity, and referral source. Our primary outcome was distance traveled from a person’s residence to the study center. Results We enrolled 399 women, 139 in 2011 and 260 in 2017. In 2011, 72% (100 of 139) traveled more than 25 miles, compared with 75% (195 of 260) in 2017. Fewer women traveled greater than 100 miles from their residence to our clinic in 2011 (20%) compared to 2017 (26%). Fewer women from neighboring states were seen in 2011 than 2017 (p = .04). Women seeking abortion in 2011 were 4 times less likely to have been referred from a freestanding abortion clinic compared with women in 2017 (9% [13 of 139] versus 37% [96 of 260]). Limitations The tertiary referral nature of our study limits generalizability. With 2 time-distinct cohorts, there may be factors that changed over the study period that remain unaccounted for. Conclusions A similar proportion of women traveled more than 25 miles for abortion before and after the legislative changes. Our finding that more women traveled greater than 100 miles to obtain an abortion in 2017 compared to 2011 highlights a key burden to abortion ac­cess in North Carolina. The increased number of women seen from freestanding abortion centers and from neighboring states following the legislative changes highlights an important geographical burden potentially associated with strict abortion restrictions.

INTRODUCTION: North Carolina enacted five statutes restricting abortion between 2011 and 2016. Our objective was to compare the proportion of women who traveled more than 25 miles to a southern tertiary care center in 2011 to the proportion of women who traveled more than 25 miles to this center in 2017. METHODS: We conducted a time-series retrospective cohort study of women who obtained an abortion at University of North Carolina Hospitals in 2011 and 2017. We collected data regarding residence, demographics, gestational age, indication, parity, and referral source. Our primary outcome was distance from self-reported residence to the study center. RESULTS: We enrolled 405 women, 143 in 2011 and 262 in 2017; groups were similar in age, parity, and ethnicity. In 2011, 72% (103/143) traveled more than 25 miles, compared with 75% (196/262) in 2017 (P=.473). In 2011, the maximum miles traveled was 290 compared to 420 in 2017. More women from neighboring states were seen in 2017 than 2011. Women seeking abortion in 2017 were four times more likely to have been referred from a freestanding abortion clinic compared with women in 2011 (38% [39/262] vs 9% [13/143]). CONCLUSION: In our tertiary care center, there was no difference in distance traveled for abortion before and after the legislative changes. However, the increased number of women seen from outside health centers and neighboring states following the legislative session may indicate additional barriers to abortion access, potentially related to increased time commitment, number of visits, and number of open clinics.