Vol. 37, No. 1, Winter 2015 30 PRACTICING ANTHROPOLOGY By Bayla Ostrach and Jessica Matthews Introduction W omen seeking abortion frequently encounter barriers that may be socioeconomic, logistical, or social. Of particular concern for policy develop- ment, women of lower socioeconomic status are more affected by these barri- ers (Jones and Weitz 2009). The focus of this article is to describe the process by which applied medical anthropol- ogy research was transformed into a joint medical anthropology/public health effort to reduce these barriers. The desired outcome was to create policy change to improve reproduc- tive health care access for low-income women in Oregon. Working in the traditions of applied and critical medi- cal anthropology to improve access to reproductive health care, we sought to utilize data to effect policy improve- ments and to offer women a tool to advocate on their own behalf. Through an earlier mixed-methods study conducted at an abortion clinic, the irst author, Ostrach, found that the process of applying for Oregon’s state-run Medicaid program (referred to as the Oregon Health Plan or OHP) that covers abortion produced notable obstacles 1 to abortion for low-income women (Ostrach and Cheyney 2014). As an applied medical anthropologist, Ostrach developed her original re- search with the intention of document- ing women’s lived experiences with accessing abortion care, a contested and marginalized form of reproductive health care, in the hopes of illuminat- ing one form of gendered disparities. The hope all along was to eventually use the data produced through this FROM RESEARCH TO POLICY CHANGE: ADDRESSING DISPARITIES AMONG LOW-INCOME WOMEN SEEKING ABORTION IN OREGON medical anthropology study to advo- cate for applied interventions to reduce such inequalities. We entered into the advocacy project described here with the goal of fully implementing the value of applied medical anthropol- ogy—to improve marginalized popula- tions’ access to care. Oregon is one of a rapidly dwindling number of scarcely more than ifteen states in the nation that fund abortion for women covered by Medicaid. Funding is provided through state-level exceptions to the Hyde Amendment, which bans the use of federal funds for most abortions (Guttmacher Institute 2014). Barriers related to Medicaid eligibility and cov- erage are well-known to disproportion- ately affect women in poverty, whose income-based eligibility suggests they are at higher risk for encountering other socioeconomic and logistical bar- riers. Women in poverty may be more affected by dificulties with transporta- tion, the need to take time off work, and paying for childcare (Jones and Weitz 2009). Staff at the clinic where data were collected noted that patients complained about delays in obtaining coverage, and unanimously agreed that waiting for OHP coverage was a noticeable risk factor for being delayed into later stages of pregnancy. Based on these indings (Ostrach and Cheyney 2014), second author Matthews developed an unpaid legisla- tive internship, working with a Demo- cratic state representative’s ofice to improve OHP accessibility and shorten waiting periods for eligible pregnant women through state-level policy ef- forts. She did so as a community-based intern for a master’s program in public health (MPH) at an Oregon university. Matthew’s emphasis on maternal-child health disparities within the MPH program motivated her interest in this topic. She volunteered by perform- ing data-entry for the study prior to beginning her internship, and sought Ostrach’s support for developing this project designed to apply anthropologi- cal indings to public policy. In discussing the earlier indings, we concluded that dificulties with OHP represented a systemic obstacle to abortion access that could potentially be addressed through public health- focused advocacy more readily than some of the other obstacles identiied. Within just a year from the comple- tion of the study, our combined efforts resulted in a new binding policy trans- mittal that was sent out by administra- tors of the state health agency to all OHP eligibility workers. This transmit- tal directed all staff to prioritize and expedite applications from pregnant women regardless of the intended outcome of the pregnancy. Moreover, workers were speciically directed to process pregnancy-related OHP appli- cations within one to two business days after receiving them; each regional of- ice was required to create an internal procedure to ensure that occurred. Medicaid Obstacles and Abortion Access in Oregon The original study was designed as an applied anthropology project. It explored whether women coming to one clinic in Oregon encountered obstacles to abortion access, what those obstacles were, and how women overcame them. Using modiied grounded theory data collection and analysis techniques, Ostrach employed a critical medical anthropology approach (Singer 1986), with a focus on the ways low socio- economic status and marginalization present more obstacles to reproductive health care for some (Jones and Weitz