Time Pressures and Sociocultural Constraints Affecting Access to Early Abortion Care Under Texas' "6-Week" Ban.

Introduction: In 2021, Texas Senate Bill 8 (SB8) prohibited abortion after detection of embryonic cardiac activity and was often referred to as a "6-week ban." Limited evidence exists about how these laws intersect with people's processes seeking pregnancy confirmation and navigating barriers to abortion care. Methods: Between October 2021 and August 2022, we recruited Texans ≥ 15 years of age who were seeking abortion using online ads and flyers placed in out-of-state abortion-providing facilities. Participants completed in-depth interviews, and we coded transcripts using inductive and deductive coding. This analysis explores participants' discussions of time needed for pregnancy confirmation, decision making, and access to care in the context of SB8. Results: Most of the 107 participants identified their pregnancy soon after a missed period, but they often sought additional pregnancy confirmation, which delayed care. Participants expressed urgency around their search for abortion after learning about the "6-week ban." Those who experienced financial, transportation, and work-related barriers felt there was insufficient time to get in-state care; others felt rushed to make a decision. Many recounted difficulties scheduling in-state appointments and were upset when facility staff denied care based on medical conventions for pregnancy dating and detection of cardiac activity before 6 weeks' gestation. Discussion: Framing SB8 as a "6-week ban" created stress among Texas abortion seekers, and the accumulation of small delays limited access to in-state care. Policy Implications: Clearer messaging around when abortion is prohibited and free, accessible pregnancy confirmation services inclusive of all care options would better support pregnant people's abortion care navigation.