Mapping Access to Abortion from Prisons and Immigration Removal Centres in the United Kingdom, British Crown Dependencies, and the Republic of Ireland

Objectives
Despite legalization, barriers to accessing abortion persist in the United Kingdom, Republic of Ireland and British Crown Dependencies, including distance to care. These barriers may be exacerbated for people incarcerated or detained in prisons and Immigration Removal Centres (IRC). This study aimed to identify the distance from prisons and IRCs to the nearest public abortion providing service in the United Kingdom, Republic of Ireland, and British Crown Dependencies.

Study design
We identified facilities that detain women and girls and public services that provide abortion by conducting an environmental scan of publicly available sources. Travel distances were calculated using OpenStreetMap data and the Open Source Routing Machine (OSRM).

Results
We identified 34 prisons and IRCs designated to detain women and girls, and 204 public abortion providing services. Of the 34 prisons and IRCs, 26% (n = 9) were located 0–10 km from an abortion service; 29% (n = 10) were located at a distance of 10.1–20 km; and 44% (n = 15) were located at a distance of 20.1–61 km.

Conclusions
While distances from prisons to public services that provide abortion are relatively short, variations in gestational limits and availability of medication or procedural abortion may require people to travel further to access care, including travel to another country. The prison environment may slow healthcare request processes and constrain access to medical transport resources. This is a particular concern in locations where limited or no abortion care is legally available after 12 weeks.

Implications
Distance represents only one potential barrier facing incarcerated women who need to access abortion services in the United Kingdom, Republic of Ireland, and British Crown Dependencies. Future research should examine policies that govern access to abortion, and the experiences of both people accessing abortion and health professionals delivering abortion services in a carceral context.