Abortion law changes adversely affect women

  • Obstet Gynecol

  • International Clinical Digest
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Takeaway

  • Implementation of Texas House Bill 2 delayed access to care and an increased number of riskier procedures.

Why this matters

  • The bill had 4 provisions:
    • physicians needed admitting privileges at a hospital within 30 miles;
    • provision of medication abortion had to follow FDA-approved label for mifepristone;
    • most abortions >20 weeks postfertilization prohibited; and
    • abortion facilities had to meet ambulatory surgical center standards (temporarily blocked).

Key results

  • Mean gestational age increased (7.3 to 8.3 weeks) after bill implementation (P<.001>
  • Second-trimester abortions increased (10.5% to 14.5%; P<.001>
  • In both periods, women who were age 
  • Next appointments as long as 26 days from date of initial call after bill implementation.

Study design

  • Statistics on abortions performed in Texas retrieved from Department of State Health Services, 2011-2014 (before and after bill).
  • Monthly mystery client calls to determine if facility was providing abortions and number of days until next available appointment.  
  • Primary outcome: occurrence of second-trimester abortions.
  • Funding: Susan Thompson Buffett Foundation, others.

Limitations

  • Distance from abortion facility, provision of medical abortion may be underestimated.