Adolescents and poor women are more likely than other women to have trouble obtaining an abortion early in pregnancy, when the procedure is safest and least expensive, according to "Timing of Steps and Reasons for Delays in Obtaining Abortions in the United States," by Lawrence B. Finer et al., published in the October 2006 issue of Contraception. The study found that a woman typically first suspects she is pregnant just over a month after her last period. Once pregnancy is suspected, most women who want an abortion act fairly quickly and are able to obtain an abortion in the first trimester.

However, Dr. Finer and his colleagues report that two groups of women —adolescents and poor women—have greater difficulty obtaining an early abortion, but for very different reasons: Teens are hampered by a lack of knowledge about the symptoms of pregnancy, while poor women’s financial constraints are often an obstacle to timely receipt of services.

For adolescents, the time between their last period and suspecting they are pregnant is significantly longer than for adult women. The authors assert that a lack of knowledge about the basic aspects and specific signs of pregnancy impedes teens’ ability to recognize a pregnancy, and suggest that increased instruction on such topics in sexuality education programs would help overcome these problems.

Poor women take significantly longer than other women from the time they first try to obtain an abortion to when they actually have the procedure, most frequently because they need to raise money for the procedure. In some cases, women make and cancel multiple appointments before they are able to get the necessary funds, or they wait days or even weeks until they can get Medicaid coverage (which is only broadly available in 17 states). The authors suggest that these findings indicate the importance of financial support for low-income women when they seek abortion.

"Abortions obtained earlier in pregnancy are safer, less expensive and less stigmatized than abortions obtained at later gestations," says Dr. Finer, director for domestic research at the Guttmacher Institute. "If the financial barriers faced by disadvantaged women were removed, and if women—particularly young women—were better educated about how to recognize a pregnancy, more women would be able to access abortion earlier, making the procedure safer."