“I am so glad to have found you”: An Investigation into the Pathways to Care leading to Aid Access Services.

Abstract

In recent years, the United States has experienced a series of political regressions in its delivery and access to reproductive healthcare; specifically, abortion care. Aid Access is a grassroot organisation founded by Dr Rebecca Gomperts, an abortion care activist. Aid Access’s primary goal is to ensure that women in the United States can access medical abortion without requiring in-person medical care, also known as telemedicine. This system allows women to carry out their healthcare needs in privacy, no matter what the legal status of abortion care is in their state. As a cyberactivist organisation, Aid Access uses social media as its main public outreach method, yet near-constant censorship has limited its outreach potential. Using Social Reproduction Theory (Arruzza et al., 2017) to explain the commodification of healthcare in conjunction with neoliberal feminism (Mann & Berotti, 2024), this research shall explore how these two facets clash alongside the rise of pronatalist politics (Rasmussen, 2023) to limit access to abortion care. As this research shall explore, the use of the internet is integral for US women to access abortion care (Guendelman et al., 2020), yet there has been an observed increase in anti-abortion deliberate misinformation being spread online (Kissling et al., 2023). As such, while Aid Access is aware that there are these several barriers to women finding out about the service, there has not yet been a definitive exploration of how women currently find out about Aid Access. These ‘pathways to care’ have been explored in a dual perspective, following two interviews with Aid Access internal staff members. The interviews identified that current political changes have directly impacted Aid Access due to recurring online censorship of their pages, yet an online network of activists and social media users has developed, in which they all share Aid Access information on their digital spaces. Three months of evaluation survey results identified that the use of social media is the most prominent pathway that links service users to Aid Access, which contradicts the assumption that word-of-mouth is the primary element. Finally, a critical discourse analysis through a digital ethnography on Reddit identified how Aid Access is discussed online – what the fears and concerns are, and what sort of information about Aid Access is communicated on, thus helping to identify the importance of a community support network within access to abortion care. This research contributes to Aid Access directly as it concludes with a series of recommendations, developed to increase and improve service outreach methods due to the increasing risk of politically charged censorship with the rise of pronatalist policies. These recommendations, while targeted to the use of digital platforms, also engage with a service limitation due to its online positionality and perceived lack of physical outreach methods, as they recommend how to provide tools for service users to engage with their social publics. By employing social media activism (Verhagen et al., 2021), engaging with service users to facilitate old-school activism to facilitate in-person mobilisation ( Lovejoy & Saxton, 2012) and suggestions on how to use Reddit as an outreach platform, Aid Access could combat the constant risk of censorship and therefore continue to be found by their service users.