Country/area: United States
Organisation: Access Atlas
Organisation size: Small
Publication date: 15/01/2021
Credit: Charlotte Evans, Io Jones, Tara Gallagher
Charlotte Evans is an Master’s student in Population Health Sciences at the University of Cambridge. She grew up internationally and has a B.A. in Geography from Dartmouth College. Prior to graduate school Charlotte spent two years conducting health system evaluation research in the Northwest Territories of Canada in collaboration wih Indigenous governments. She is commited to ensuring equitible access to health care services and pursues this goal through the development of projects including Access Atlas and initiatives to ensure youth leadership in the design and delivery of mental healthcare.
Io Jones is a student at the University of Virginia School of Law. She grew up in Brooklyn, New York ad has a B.A. in Geography and Public Policy from Dartmouth College. Prior to law school she worked as a litigation paralegal and conducted research on abortion access during the COVID-19 pandemic with the Access Atlas team. She has conducted a range of research projects on access to abortion, crisis pregnancy centers, and state, national, and global health policy.
Tara is a first-year environmental science PhD student at Harvard University exploring connections between climate change and the water cycle. She grew up in Burlington, Vermont and has a B.A. in physics and music from Dartmouth College. Before graduate school, she spent two years working as a signal processing researcher on government contracts, and collaborated with both Harvard’s Center for Communicable Disease Dynamics and the Access Atlas team on studies related to infectious disease and reproductive health respectively.
As the first wave of the COVID-19 pandemic peaked in the United States, abortion bans were instituted in many states under the guise of safeguarding public health. In response, Access Atlas was founded to track abortion bans and restritions set in place throughout the pandemic complemented by local narratives from abortion providers that illustrate their iniquitous impact. Since its inception, Access Atlas continues to develop resources to equip people with necessary and accessible information regarding the practical implications of confusing state laws and policies on abortion care.
Our project provided a vital source of information for everyone from journalists to people seeking abortions during a time when reproductive healthcare was under attack, but not regularly covered in the news. While media outlets covered some high profile battles over abortion access, the availability of abortion and other reproductive healthcare was unclear in many parts of the country in the early months of the COVID-19 pandemic. In the months of April and May 2020, our website and maps were the only consistently updated source of this aggregated data.
Our maps and information provided timely, accurate, and accessible information to the public on three key questions: (1) Are abortion services available in my state during the pandemic? (2) What policy restrictions, if any, exist to limit access? (3) How were abortion services defined in initial COVID-19 executive orders and statements in my state? We designed these resources to assist both individuals looking for information about their healthcare options and researchers looking for accurate data. Beyond abortion availability, these resources identify the gap between technical laws and actual abortion accessibility in each state and arm viewers with clear information about statewide abortion restrictions designed to limit access.
When states began to loosen COVID-19 restrictions, we continued to track abortion availability and accessibility, recognizing the public confusion and uncertainty in this time period. By conducting interviews with abortion providers in 2021, we were able to identify the ways in which providers were uniquely impacted by state policies during this time and shared our findings through a series of blog posts to complement our collected data.
Access Atlas presents a set off three maps that capture and track the availability of abortion services in the United States during the COVID-19 pandemic. An excel database was developed using information collected from news articles, policy and legal documents and resources as well as clinic interviews. Analysis of this database yielded three important quantitative measures displayed within our maps that together communicate a digestible snapshot of abortion access in America.
While this research exposed the uneven impacts of state-level responses to the COVID-19 crisis on abortion access, our analysis of their implications lacked local narrative. In January 2021, we called clinics in the 11 states that classified abortion as non-essential in initial government orders to understand the impacts of the pandemic on individual clinics. We collected both quantitative and qualitative data on over ten clinic level variables and published our findings in a series blog post that explored areas of commonality and difference in clinic experiences. The goal of this blog series was to highlight the unique experiences that clinics and their clients have had to navigate and overcome throughout the COVID-19 crisis and the need to support abortion providers now more than ever.
What was the hardest part of this project?
The challenge of developing Access Atlas fell into two main categories: the practical issues associated with culling data, and the theoretical uncertainties we had about presenting the results. As recent graduates working without funding or institutional support, we spent our limited time outside our newly-remote first day jobs brainstorming how best to determine and relay critical information regarding abortion availability and access across the US. Despite hours spent reading news articles, executive orders, and government press statements, it remained unclear where people were able to access abortion services, and how people were expected to monitor changes in their availability.
Given the highly nonbinary nature of the question we were trying to answer, we devised a digestible “COVID-19 abortion restriction score” to characterize the various ways in which abortion availability could be threatened, then went state-by-state gathering data from a diverse range of trusted sources. This kept results simple but robust in that they contained a great deal of information: for example, this allowed us to capture where abortion was available, where surgical abortions were banned but telemedicine was available, or where restrictions limited the ability of providers to delegate tasks. We continued to review and update this information once the website launched, especially where accessibility was uncertain; we also brought two undergraduate research assistants onto our team.
More broadly speaking, we struggled to identify our audience. We wanted this information to be available to people seeking services themselves, but recognized that, given our resources and limited background in app development, it was more feasible to focus on the academic and research community. Ultimately, all of these decisions paid off, and we were able to collaborate with current students from Wellesley College, Vanderbilt University, and Georgetown University (see their writeup at: https://www.hyasforchoice.com/single-post/2020/05/31/access-atlas-mapping-abortion-restrictions-in-the-time-of-covid).
What can others learn from this project?
The landscape of abortion availability and access in the United States is unstable and changes according to political will or global pandemics. In addition, the intricacies of access to abortion services vary from state to state and new legislation and restrictions are often difficult to predict and track. Our team was challenged by the fickle nature of abortion access across the country. Sudden changes in accessibility required rapid updates to our website and this conflicted with our mission to provide our audience with accurate and well researched information.
Our team dealt with this conflict via transparency. We informed our audience about the limitations of our data, measurements and analysis as well as provided them with our sources. As journalists covering abortion in the United States our responsibility was not only to provide our audience with data and information, but also the necessary resources for to think critically about and evaluate the evidence we are presenting. This responsibility is often forgotten or intentionally ignored within journalism, especially journalism covering politically frought topics such as abortion.
We also believe that our project demonstrates the importance of engaging youth in data reporting and journalism. Our project engaged university students as research assistants and collaborated with reproductive justice university groups on social media campaigns. We hope to continue to provide an inclusive platform which nurtures the energetic and visionary voices of youth and provides them with leadership opportunities.