Experiences of delay-causing obstacles and mental health at the time of abortion seeking

Wasser, Ortal; Ralph, Lauren J.; Kaller, Shelly; Biggs, M. Antonia

doi:10.1016/j.conx.2024.100105

Cited by 3 publications

(3 citation statements)

References 34 publications

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“… 26 While the average increase from around 9 to 10 weeks could push people near or beyond eligibility for medication abortion, studies have found that any delay increases the risk of complications 27 and can have negative impacts on psychological well-being. 28 Thus, this potential early trend is concerning given the economic and health implications of later abortion care. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

“…First, this early trend of an approximate 1 week increase in gestational duration after Dobbs is worrisome given the economic and health implications of delayed care and later abortions. 24 , 27 , 28 Strengthening existing primary care and telehealth accessibility, financial support, and referral systems within the state could address these delays by expanding accessibility to earlier abortion care. Increased public education and awareness about where and how to seek abortion care in Washington can also help reduce delays.…”

Section: Discussionmentioning

confidence: 99%

“…have negative impacts on psychological well-being. 28 Thus, this potential early trend is concerning given the economic and health implications of later abortion care. 29,30 We also generated new insights into the sociodemographic shifts in abortion access after Dobbs.…”

Section: This Aligns With Other Studies Showing Increases In the Numb...mentioning

confidence: 99%

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Abortion Provision and Delays to Care in a Clinic Network in Washington State After Dobbs

Riley,

Fiastro,

Benson

et al. 2024

JAMA Netw Open

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ImportanceThe Supreme Court decision Dobbs v Jackson Women’s Health Organization (Dobbs) overturned federal protections to abortion care and altered the reproductive health care landscape. Thus far, aggregated state-level data reveal increases in the number of abortions in states where abortion is still legal, but there is limited information on delays to care and changes in the characteristics of people accessing abortion in these states after Dobbs.ObjectiveTo examine changes in abortion provision and delays to care after Dobbs.Design, Setting, and ParticipantsRetrospective cohort study of all abortions performed at an independent, high-volume reproductive health care clinic network in Washington state from January 1, 2017, to July 31, 2023. Using an interrupted time series, the study assessed changes in abortion care after Dobbs.ExposureAbortion care obtained after (June 24, 2022, to July 31, 2023) vs before (January 1, 2017, to June 23, 2022) Dobbs.Main Outcome and MeasurePrimary outcomes included weekly number of abortions and out-of-state patients and weekly average of gestational duration (days) and time to appointment (days).ResultsAmong the 18 379 abortions during the study period, most were procedural (13 192 abortions [72%]) and funded by public insurance (11 412 abortions [62%]). The mean (SD) age of individuals receiving abortion care was 28.5 (6.44) years. Following Dobbs, the number of procedural abortions per week increased by 6.35 (95% CI, 2.83-9.86), but then trended back toward pre-Dobbs levels. The number of out-of-state patients per week increased by 2 (95% CI, 1.1-3.6) and trends remained stable. The average gestational duration per week increased by 6.9 (95% CI, 3.6-10.2) days following Dobbs, primarily due to increased gestations of procedural abortions. The average gestational duration among out-of-state patients did not change following Dobbs, but it did increase by 6 days for in-state patients (5.9; 95% CI, 3.2-8.6 days). There were no significant changes in time to appointment.Conclusions and RelevanceThese findings provide a detailed picture of changes in abortion provision and delays to care after Dobbs in a state bordering a total ban state. In this study, more people traveled from out of state to receive care and in-state patients sought care a week later in gestation. These findings can inform interventions and policies to improve access for all seeking abortion care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Abortion Provision and Delays to Care in a Clinic Network in Washington State After Dobbs

Riley,

Fiastro,

Benson

et al. 2024

JAMA Netw Open

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What Is the Impact of Having an Abortion on People’s Mental Health?

Biggs,

Foster

2024

The Mental Health Clinician’s Handbook for Abortion Care

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Patient navigation in reproductive healthcare

Schechter,

Espey,

Krashin

2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review This review summarizes evidence about barriers to abortion care pre-Dobbs and post-Dobbs, inequities in abortion access, and approaches to improving access to abortion care with use of patient navigators. Recent findings The Dobbs decision and resulting state-level restrictions exacerbated economic, knowledge, and logistic barriers to abortion care. Abortion funds and emotional support are two main resources to help address these barriers; however, only with coordination can patients and clinics fully benefit from the resources. Patient navigation provides that coordination. Evidence shows it improves reproductive outcomes, is acceptable to patients and providers, and engages community health workers and community-based organizations. Summary Increasing legal restrictions and barriers to abortion care have motivated advocates to identify effective interventions to facilitate patient-centered and culturally competent care. Navigators have improved postpartum care by increasing attendance, education and helping coordinate overall care. They have improved referrals and access to abortion care in statewide programs.

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Experiences of delay-causing obstacles and mental health at the time of abortion seeking

Cited by 3 publications

References 34 publications

Abortion Provision and Delays to Care in a Clinic Network in Washington State After Dobbs

Abortion Provision and Delays to Care in a Clinic Network in Washington State After Dobbs

What Is the Impact of Having an Abortion on People’s Mental Health?

Patient navigation in reproductive healthcare

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