A sweeping new survey about abortion in Massachusetts finds that, in a state with well-supported abortion funds and broad access to telemedicine abortion, awareness of those resources is still limited.

The findings come from a Massachusetts community scan released last week that was conducted by New York-based Southpaw Insights at the request of Tides for Reproductive Freedom.

About 60% of the respondents — nearly 1,000 people ages 16-54 who could become pregnant — knew where they would get an abortion if they wanted one. Fewer than half said they were aware that getting abortion by telehealth is an option.

Feyla McNamara, a co-executive director at Tides, says the survey findings provide a roadmap of what they do next, such as awareness campaigns and investing more in support services. Tides, a statewide abortion fund, uses donations and state grants to pay for abortions in Massachusetts.

“The increase in telemedicine and accessing abortion through telemedicine is going to be a gamechanger for folks in Western Massachusetts,” McNamara said, citing lower awareness of abortion options in central and western parts of the state.

Under abortions by telemedicine, a pregnant person in their first trimester communicates with a provider by a call or even an online form and is prescribed pills to induce an abortion. That medication is then mailed to their house or can be picked up in person at a pharmacy or provider’s office.

Dr. Angel Foster, who co-founded the Massachusetts Medication Abortion Access Project, said telemedicine abortion currently accounts for about 20% of abortions nationwide. Based in Cambridge, Foster’s organization offers medication abortion by telehealth in all 50 states, though it focuses on those with strict restrictions like Texas and Florida. Still, she’s not surprised many people still don’t know about the option.

“Most people — even if they care a lot about reproductive health rights and justice — don’t necessarily know a lot of the details of the kinds of services and what’s available until they’re actually looking for that service,” she said.

But awareness is increasing. In this new Massachusetts survey, 42% of respondents were aware of telehealth abortion. Just five years ago, only 1 in 5 Americans had heard of medication abortion at all, per KFF polling.

Rebecca Hart Holder, the executive director of Reproductive Equity Now, agrees that telemedicine is a cornerstone of expanding abortion access in the commonwealth: it’s more accessible and comes with fewer costs than an in-office procedure.

“The focus on the rights is incredibly important,” Hart Holder said, “but the nuts and bolts of how are you paying for care? How do you get time off from work? What does transportation look like? That all plays into whether or not you can actually access care.”

Survey respondents who’d gotten an abortion themselves in the last decade estimated that it had cost them on average nearly $900.

“They still were averaging paying over $200 out of pocket for the abortion itself and then ... an additional $600 and $700 on the other expenses,” McNamara said. “And those rang true for what we thought folks were spending money on. We knew people are losing wages, we know that people are spending money on child care and on meals and on lodging and on travel.”

To McNamara, that finding underscored why advocates need to expand the focus beyond the cost of the procedure itself to offer “practical support,” as abortion funds refer to it: helping pay for related costs such as child care and transportation.

In terms of public opinion, residents surveyed were overwhelmingly supportive of abortion rights and public funding for abortion. But they were divided on whether minors seeking abortions should have to get parental approval. About half of respondents agreed that they should.

Massachusetts was the first state to legislate parental consent for abortion for minors in 1974. Since 2020, that age has been lower: 16. Lawmakers rolled back restrictions over Gov. Charlie Baker’s veto. Patients 15 and younger still need a parent’s approval, or permission from a judge.

“That is a barrier to care,” Hart Holder said. “We know that it’s really impacting the most vulnerable.”

Many advocates, including Hart Holder, would like to see it repealed altogether.