Overview
Access to abortion care is essential for the health and well-being of all individuals. While there is a substantial body of scientific research supporting both the importance and safety of abortion, many individuals face myriad obstacles to obtain abortion-related healthcare or are denied access to it. Restrictive abortion laws and policies laid down in the name of health and safety do not serve the stated purpose, but cause severe hardship and stress both to those seeking to end a pregnancy and to their families. As a result, black and other people of color, indigenous people, low socioeconomic and impoverished individuals, rural-based, teens, and LBGTQ+ individuals among others are disproportionately impacted to accessing abortion care.
Interactive Map: US Abortion Policies and Access After Roe https://states.guttmacher.org/policies/utah/abortion-policies (updated 2023)
State Legislation Tracker
Major Developments in Sexual & Reproductive Health
https://www.guttmacher.org/state-legislation-tracker (updated June 1, 2023)
Guttmacher Institute, “An Overview of State Abortion Laws”, State Laws and Policies, 1 January, 2023, https://www.guttmacher.org/state-policy/explore/overview-abortion-laws
Guttmacher Institute, “State Legislation Tracker”, Major Developments in Sexual and Reproductive Health, 31 December 2022, https://www.guttmacher.org/state-policy#
Guttmacher Institute, “State Legislation Tracker”, Major Developments in Sexual and Reproductive Health, Targeted Regulation, 1 January 2023 https://www.guttmacher.org/state-policy/explore/targeted-regulation-abortion-providers
In re Whole Woman’s Health, et al. On Petition for Writ of Mandamus No. 21-962, January 20, 2022
https://www.supremecourt.gov/opinions/21pdf/21-962_n6io.pdf
Supreme Court of Texas, No. 22-0033 ( March 11, 2022)
Whole Woman’s Health, et al., Plaintiffs-Appellees, v. Judge Austin Reeve Jackson; Penny Clarkston; Mark Lee Dickson; Stephen Brint Carlton; Katherine A. Thomas; Cecile Erwin Young; Allison Vordenbaumen Benz; Ken Paxton, Defendants-Appellants
On Certified Question from the United States Court of Appeals for the Fifth Circuit
Gender Justice and Lawyering Project
https://www.supremecourt.gov/DocketPDF/19/19-1392/192984/20211004121237069_main%2019-1392.pdf
The Lawyers’ Committee for Civil Rights Under Law
https://www.supremecourt.gov/DocketPDF/19/19-1392/193123/20210921090114082_19-1392bsacLawyersCommitteeForCivilRightsUnderLaw1.pdf
AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS,
https://www.supremecourt.gov/DocketPDF/19/19-1392/193074/20210920174518042_19-1392%20bsacACOGetal.pdf
National Women’s Law Center
https://www.supremecourt.gov/DocketPDF/19/19-1392/192909/20210920125441954_19-1392%20Thomas%20E%20Dobbs%20v%20Jackson%20Womens%20Health%20Brief%20of%20Amici%20in%20Support.._.pdf
Human Rights Watch
https://www.supremecourt.gov/DocketPDF/19/19-1392/192874/20210920162148560_Dobbs_9.20_Clean.pdf
State Policy Trends 2022: In a Devastating Year, US Supreme Court’s Decision to Overturn Roe Leads to Bans, Confusion, and Chaos
https://www.guttmacher.org/2022/12/state-policy-trends-2022-devastating-year-us-supreme-courts-decision-overturn-roe-leads
New KFF National Survey of OBGYNs Finds Dobbs Decision Has Made It Harder to Treat Miscarriages and Other Pregnancy-Related Emergencies in Affected States; In States with Bans, Half Report Patients Who Were Unable to Obtain an Abortion They Sought
https://www.kff.org/womens-health-policy/press-release/kff-national-survey-of-obgyns-finds-dobbs-decision-has-made-it-harder-to-treat-miscarriages-and-other-pregnancy-related-emergencies-in-states-with-bans/
Key Facts on Abortion in the United States
https://www.kff.org/womens-health-policy/report/key-facts-on-abortion-in-the-united-states/
The State Abortion Policy Landscape One Year Post-Roe
https://www.guttmacher.org/2023/06/state-abortion-policy-landscape-one-year-post-roe
Inequity in US Abortion Rights and Access: The End of Roe Is Deepening Existing Divides
https://www.guttmacher.org/2023/01/inequity-us-abortion-rights-and-access-end-roe-deepening-existing-divides
Guttmacher Institute. “State Bans on Abortion Throughout Pregnancy.” State Laws and Policies, 1 January 2023, https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions.
Thompson, Alexandra et al., Guttmacher Institute. “The disproportionate burdens of the mifepristone REMS.” Contraception, July 2021, https://www.guttmacher.org/article/2021/07/disproportionate-burdens-mifepristone-rems.
Nash, Elizabeth, Naide, Sophia, Guttmacher Institute. “State Policy Trends at Midyear 2021: Already the Worst Legislative Year Ever for U.S. Abortion Rights.” Policy Analysis, 1 July 2021, https://www.guttmacher.org/article/2021/07/state-policy-trends-midyear-2021-already-worst-legislative-year-ever-us-abortion.
Institute for Women’s Policy Research. An Economic Case for Ending Harmful State Policies. The Costs of Reproductive Health Restrictions, https://iwpr.org/costs-of-reproductive-health-restrictions/.
The American College of Obstetricians and Gynecologists (ACOG), Guide to Language and Abortion
The Guide provides medically accurate terminology to discuss abortion Available at: https://www.acog.org/-/media/project/acog/acogorg/files/pdfs/publications/abortion-language-guide.pdf?la=en&hash=EDDEB0D9B24B7427A8F52378FA72E092
Safe abortion: technical and policy guidance for health systems, second edition, World Health Organization (2019)
https://apo.who.int/publications/i/item/safe-abortion-technical-and-policy-guidance-for-health-systems-second-edition
Abortion ban causes outsized harm to people of color
https://www.apa.org/monitor/2023/06/abortion-bans-harm-people-of-color
Care Post-Roe: Documenting cases of poor-quality care since the Dobbs decision
https://www.ansirh.org/sites/default/files/2023-05/Care%20Post-Roe%20Preliminary%20Findings.pdf
Abortion Care Guideline (WHO)
https://www.who.int/publications/i/item/9789240039483
Obstacles to Care Mount 1 Year After Dobbs Decision (ANSIRH)
https://jamanetwork.com/journals/jama/fullarticle/2806685
The facts about abortion and mental health
https://www.apa.org/monitor/2022/09/news-facts-abortion-mental-health
Fact Sheet (ACOG)
https://www.acog.org/womens-health/faqs/induced-abortion
Safe abortion: technical and policy guidance for health systems, second edition, World Health Organization, Department of Reproductive Health and Research, 2012, available at: https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/.
The Safety and Quality of Abortion Care in the United States, The National Academies of Sciences, Engineering and Medicine, 2018. Download a no-cost copy of the report at: https://www.nap.edu/catalog/24950/the-safety-and-quality-of-abortion-care-in-the-united-states
See also, Public Report Webinar: The Safety and Quality of Abortion Care in the United States, Committee on Reproductive Health Services, Assessing the Safety and Quality of Abortion Care, March 23, 2018, at: https://www.youtube.com/watch?v=RsTWN947ahE
Introduction to the Turnaway Study, Research on Abortion Care, Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco Medical Center, Bixby Center for Global Reproductive Health, March 2020, available at: https://www.ansirh.org/research/ongoing/turnaway-study
Effects of Carrying an Unwanted Pregnancy to Term on Women’s Existing Children.” The Journal of Pediatrics, vol. 205, 2019, pp. 183-189. ScienceDirect, https://www.sciencedirect.com/science/article/pii/S0022347618312976.
Abortion and Mental Health, American Psychological Association, June 2018, available at: https://www.apa.org/pi/women/programs/abortion
Induced Abortion and Breast Cancer Risk, The American College of Obstetricians and Gynecologists, ACOG Committee Opinion, Number 434, June 2009 at: https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2009/06/induced-abortion-and-breast-cancer-risk.pdf
Abortion Surveillance — United States, 2020
https://www.cdc.gov/mmwr/volumes/71/ss/ss7110a1.htm#methods
A Review of Exceptions in State Abortions Bans: Implications for the Provision of Abortion Services
https://www.kff.org/womens-health-policy/issue-brief/a-review-of-exceptions-in-state-abortions-bans-implications-for-the-provision-of-abortion-services/
According to the Kaiser Family Foundation, 92% of abortions occur in the first trimester of pregnancy. Furthermore, 43% of abortions occur by six weeks gestation, 36% occur between seven and nine weeks, and 13% occur at 10 to 13 weeks. Ranji, Usha, Diep, Karen, Salganicoff, Alina. “Key Facts on Abortion in the United States.” Kaiser Family Foundation, 12 July 2022, https://www.kff.org/womens-health-policy/report/key-facts-on-abortion-in-the-united-states/#At-what-point-in-pregnancy-do-abortions-occur
According to the Centers for Disease Control and Prevention’s (CDC) 2018 Surveillance Reporting for Abortions in the U.S, 619,591 abortions were reported to the agency from 49 reporting areas. According to the report, 77.7% of individuals had abortions at or before 9 weeks gestation, and 92.2 % had abortions at or before 13 weeks gestation. Kortsmit K, Jatlaoui TC, Mandel MG, et al. Abortion Surveillance — United States, 2018. MMWR Surveill Summ 2020;69(No. SS-7):1–29. DOI: http://dx.doi.org/10.15585/mmwr.ss6907a1
International Comparison
https://www.commonwealthfund.org/blog/2023/limiting-abortion-access-american-women-impacts-health-economic-security
1 Year Without Roe
https://www.americanprogress.org/article/1-year-without-roe/
Dobbs: Navigating the New Quagmire and Its Impacts on Abortion and Reproductive Health Care
https://journals.sagepub.com/doi/full/10.1177/10901981221125430?casa_token=vvSuWi15NEMAAAAA%3A0OTL0s986jUrDnBOgWW3J8fhQ1fZ-c_47pG8L2t4RhraP38AmiaXFhhujIi-NCVOHSvtXiXZ17yM
Impact of the Dobbs Decision on Medical Education and Training in Abortion Care
https://www.whijournal.com/article/S1049-3867(23)00079-8/fulltext
NYT: Kate Zernike, Sept. 10, Medical Impact of Roe Reversal Goes Well Beyond Abortion Clinics, Doctors Say
State abortion bans carry narrow but sometimes vague exceptions, and years of prison time. That’s forcing doctors to think like lawyers, and hospitals to create new protocols
Article discusses abortion ban exceptions to save the life of the pregnant person forces doctors to compromise their medical judgement concerning the best interests of the patients health and well-being and shift to legal considerations and potential criminalization for patient care.
Available at: https://www.nytimes.com/2022/09/10/us/abortion-bans-medical-care-women.html
Salon.com: Charlotte Huff, New Abortion Laws Jeopardize Cancer Treatment for Pregnant Patients In states with abortion bans, doctors have questions about how they can treat pregnant patients with cancer
Article discusses the difficulties physicians and their pregnant patients face to obtain cancer treatment in states that ban abortion but allow an exceptions for a medical emergency.
Nambiar, Anjali et al., Maternal morbidity and fetal outcomes among pregnant women at 22 weeks’ gestation or less with complications in 2 Texas hospitals after legislation on abortion, American Journal of Obstetrics & Gynecology, Research Letter, 2022, available at: https://www.ajog.org/article/S0002-9378(22)00536-1/pdf
Anderson, Elizabeth M., et al., “Willing but unable: Physicians’ referral knowledge as barriers to abortion care.” SSM – Population Health, Volume 17, March 2022, https://doi.org/10.1016/j.ssmph.2021.101002
Fulcher, Isabel R., et al., “The impact of the COVID-19 pandemic on abortion care utilization and disparities by age.” American Journal of Obstetrics and Gynecology, Volume 226, Issue 6, June 2022, https://doi.org/10.1016/j.ajog.2022.01.025
Arey, Whitney, Lerma, Klaira, Beasly, Anitra, et al., “A Preview of the Dangerous Future of Abortion Bans — Texas Senate Bill 8.” The New England Journal of Medicine, 22 June 2022, DOI: 10.1056/NEJMp2207423
Dovile Vilda, Maeve E. Wallace, Clare Daniel, Melissa Goldin Evans, Charles Stoecker, Katherine P. Theall, “State Abortion Policies and Maternal Death in the United States, 2015‒2018”, American Journal of Public Health 111, no. 9 (September 1, 2021): pp. 1696-1704. https://doi.org/10.2105/AJPH.2021.306396
American Psychological Association. “Restricting access to abortion likely to lead to mental health harms, APA asserts.” 3 May 2022, https://www.apa.org/news/press/releases/2022/05/restricting-abortion-mental-health-harms
World Health Organization, Department of Reproductive Health and Research. Safe abortion: technical and policy guidance for health systems. 2nd ed., World Health Organization, 2nd edition, 132 p., 2012, Sexual and reproductive health, https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/
National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. Download a no-cost copy of the report at: https://www.nap.edu/catalog/24950/the-safety-and-quality-of-abortion-care-in-the-united-states
Committee on Reproductive Health Services. Public Report Webinar: The Safety and Quality of Abortion Care in the United States. 23 March 2019. Assessing the Safety and Quality of Abortion Care, https://www.youtube.com/watch?v=RsTWN947ahE.
Advancing New Standards in Reproductive Health (ANSIRH). “The Turnaway Study,.” University of San Francisco, (UCSF), https://www.ansirh.org/research/ongoing/turnaway-study.
Bai, Nina. “As More States Restrict Abortions, Research Points to Negative Health Outcomes for Women, Families.” University of California at San Francisco (UCSF), 22 May 2019, https://www.ucsf.edu/news/2019/05/414551/more-states-restrict-abortions-research-points-negative-health-outcomes-women.
Rocca, Corinne H., et al., Social Science & Medicine, Emotions and Decision Rightness over Five Years: An Examination of Decision Difficulty and Abortion Stigma, Social Science & Medicine, Volume 248, March 2020, https://doi.org/10.1016/j.socscimed.2019.112704.
American Psychological Association, Abortion and Mental Health, June 2018, https://www.apa.org/pi/women/programs/abortion.
American College of Obstetricians and Gynecologists (ACOG), Induced Abortion and Breast Cancer Risk, Committee Opinion, No. 434, June 2009, https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2009/06/induced-abortion-and-breast-cancer-risk.
Cartwright, Alice F., et al. “Identifying National Availability of Abortion Care and Distance From Major US Cities: Systematic Online Search.” J Med Internet Res, vol. 20(5): e186., 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972217/.
Wolfe, Taida, and Yana van der Meulen Rodgers. “Abortion During the COVID-19 Pandemic: Racial Disparities and Barriers to Care in the USA.” Sex Res Social Policy., 2021, pp. 1-8.
The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions
https://www.commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes
Maternal morbidity and fetal outcomes among pregnant women at 22 weeks’ gestation or less with complications in 2 Texas hospitals after legislation on abortion, American Journal of Obstetrics & Gynecology, Research Letter, 2022
Study of pregnancy outcomes and morbidities for women at less than 22 weeks gestation and needing obstetrical management at 2 Texas Hospitals after Texas Bills SB 8 and SB 4 went into effect. The study involved 28 pregnant patients (less than 22 weeks gestation) presenting with obstetrical complications. Prior to the passage of Texas laws SB 4 and SB 8, these individuals would have been “,,,counseled and offered expectant management (closely monitored) or induction of labor.” After Sept. 2021, these patients were “expectantly managed with medical intervention when there was an immediate threat to maternal life.” State-mandated expectant management of obstetrical complications corresponded with significant maternal morbidity. In fact, while most of these patients presented with medical indications for delivery they endured “serious morbidity and fetal outcomes were poor.”
Available at: https://www.ajog.org/action/showPdf?pii=S0002-9378%2822%2900536-1
Nambiar, Anjali et al., Maternal morbidity and fetal outcomes among pregnant women at 22 weeks’ gestation or less with complications in 2 Texas hospitals after legislation on abortion, American Journal of Obstetrics & Gynecology, Research Letter, 2022, available at: https://www.ajog.org/article/S0002-9378(22)00536-1/pdf
Severe Maternal Morbidity in the United States, Reproductive Health, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), 2021, at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
Severe maternal morbidity (SMM) refers to labor and delivery outcomes resulting in short or long-term consequences to the person’s health. “SMM has been steadily increasing in recent years….” In 2014 (most recent available data) it has affected more than 50,000 women in the U.S.”
Severe Maternal Morbidity in the United States: A Primer
https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/severe-maternal-morbidity-united-states-primer
Maternal Mortality Rates in the United States, 2021, Hoyert, Donna L., Division of Vital Statistics, Centers for Disease Control and Prevention,
available at: dc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm#:~:text=In%202021%2C%20the%20maternal%20mortality,for%20White%20and%20Hispanic%20women
The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions
https://www.commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes
Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them
https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/#:~:text=Maternal%20and%20infant%20health%20disparities,outcomes%20for%20people%20of%20color.
What are the Implications of the Overturning of Roe v. Wade for Racial Disparities?
https://www.kff.org/racial-equity-and-health-policy/issue-brief/what-are-the-implications-of-the-overturning-of-roe-v-wade-for-racial-disparities/
Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019
https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
Trauma of abortion restrictions and forced pregnancy: urgent implications for acute care surgeons
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896239/
Updated Brief on Racial Disparities in Maternal and Infant Health
https://www.kff.org/racial-equity-and-health-policy/press-release/updated-brief-on-racial-disparities-in-maternal-and-infant-health/
NIH study suggests women with disabilities have higher risk of birth complications and death
https://www.nih.gov/news-events/news-releases/nih-study-suggests-women-disabilities-have-higher-risk-birth-complications-death
CDC: Maternal Mortality Rates in the United States, 2021, Donna L. Hoyert, Ph.D., Division of Vital Statistics. Available at: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm#:~:text=In%202021%2C%201%2C205%20women%20died,20.1%20in%202019%20(Table)
dc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.pdf
The Maternal Mortality Consequences of Losing Abortion Access, Amanda Jean Stevenson, Leslie Root, and Jane Menken, University of Colorado Boulder. Available at https://osf.io/preprints/socarxiv/7g29
Approximately 700 women die from pregnancy-related complications each year in the United States and “significant racial/ethnic disparities in pregnancy related mortality exist”. “During 2007-2016, Black and American Indian and Alaska Native women had significantly more pregnancy-related deaths per 100,000 births than did White, Hispanic, and Asian/Pacific Islander women.” Peterson, Emily et al, Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention (CDC), September 2019
https://www.cdc.gov/mmwr/volumes/68/wr/mm6835a3.htm; About Maternal Morbidity and Mortality, National Institutes of Health, February, 2022
https://www.nih.gov/research-training/medical-research-initiatives/improve-initiative/about-maternal-morbidity-mortality
In the U.S., Black women and American Indian and Alaskan Native (AIAN) women have higher rates of maternal mortality and morbidity than white women Artiga, Samantha, et al, Racial Disparities in Maternal and Infant Health: An Overview, KFF, November 2020
https://www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/
“In 2020, the maternal mortality rate for non-Hispanic Black women 2.9 times the rate for non-Hispanic White women” Hoyert, Donna L., Maternal Mortality Rates in the United States, 2020, National Center for Statistics, Centers for Diseases Control and Prevention (CDC) https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm#anchor_1559670130302
Estimates are that there will be an increase in pregnancy-related deaths if “wanted legal abortions” are prevented, even if those individuals denied an abortion do not utilize unsafe abortion methods. Additional deaths and increase in lifetime risk will be greatest among non-Hispanic Black women. A projected 33% increase in subsequent years.
Stevenson, AJ, The Pregnancy-Related Mortality Impact of a Total Abortion Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant, Demography, December 2021 https://pubmed.ncbi.nlm.nih.gov/34693444/
Four in 5 Pregnancy-related deaths in the U.S. are preventable, Press Release, Centers for Disease Control and Prevention (CDC), September 19. 2022
“More than 80% of pregnancy-related deaths were preventable, according to 2017-2019 data from Maternal Mortality Review Committees (MMRCs)…” Available at: https://www.cdc.gov/media/releases/2022/p0919-pregnancy-related-deaths.html
Dovile Vilda, Maeve E. Wallace, Clare Daniel, Melissa Goldin Evans, Charles Stoecker, Katherine P. Theall, “State Abortion Policies and Maternal Death in the United States, 2015‒2018”, American Journal of Public Health 111, no. 9 (September 1, 2021): pp. 1696-1704. https://doi.org/10.2105/AJPH.2021.306396
Maternal Mortality rates in the United States, 2020, Donna Hoyert, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), 2022. at: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm
“In 2020, maternal mortality rates for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women.” “The increases from 2019 to 2020 for non-Hispanic Black women and Hispanic women was significant.”
Study Estimating Maternal Mortality Post-Dobbs
National and State specific estimates based upon previously published statistics for maternal mortality are detailed in this study.
- The authors estimate that if none of the 2020 U.S. abortions occurred the result would be 24% more U.S. maternal deaths overall and 39% more U.S. maternal deaths among non-Hispanic Black individuals. (p.3)
- For state specific estimates see chart (p. 15)
Stevenson, Amanda J., et al. The Maternal Mortality Consequences of Losing Abortion Access. University of Colorado Boulder, SocArXiv, 29 June 2022, available at: https://osf.io/preprints/socarxiv/7g29k/
Qualitative Studies
Report: Care post-Roe (June 2022-March 2023). Qualitative Study (preliminary findings) documents cases of poor-quality care after Dobbs Study involved submissions from 50 health care providers describing detailed cases of care that deviated from the usual standard in one of fourteen states banning abortions. The reported cases detail harm to patients including increased morbidity, aggravated pregnancy complications, inability to provide time sensitive care, and more delays to receiving care. The existing disparities in healthcare for people of color has deepened.
- The Study documents a wide range of harm Cases fall into following categories (p.4);
- Obstetric complications in second trimester prior to fetal viability, including preterm labor rupture of membranes, hemorrhage, cervical dilation, and hypertension
- Ectopic pregnancy
- Underlying medication conditions that made continuing a pregnancy dangerous
- Severe fetal anomalies
- Early miscarriage
- Extreme delays in obtaining abortion care; and
- Delays obtaining medical care unrelated to abortion
Care Post-Roe: Documenting cases of poor-quality care since the Dobbs decision, Grossman D., Joffe C., Kaller S., Kimport K., Kinsey E., Lerma K., Morris N, White K, Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, May 2023, available at: https://www.ansirh.org/research/research/how-post-roe-laws-are-obstructing-clinical-care
A National Survey of OBGYN’s Experiences After Dobbs
- Nationally, in states where abortion is banned, four in ten (40%) OBGYNs report they have personally felt constraints on their ability to provide care for miscarriages and other pregnancy-related medical emergencies (p.3)
- 36% of OBGYNs nationally and 55% practicing in states where abortion is banned (or 47% practicing is states where there are gestational limits) report their ability to practice within the standard of care has become worse (p.12-13)
- Four in ten OBGYNs nationally (44%) and six in ten practicing in states where abortion is banned or where there are gestational limits, report their decision-making autonomy has become worse since the Dobbs ruling (p.3)
- 68% of OBGYNs report the ruling has worsened their ability to manage pregnancy-related emergencies (p.3)
-
- 64% believe the Dobbs decision has worsened pregnancy-related mortality,
- 70% believe the decision has worsened racial and ethnic inequities in maternal health
- 55% believe the decision has worsened the ability to attract new OBGYNs to the field
A National Survey of OBGYNs’ Experiences After Dobbs, KFF, Frederiksen, Brittni et al., June 2023, available at: https://www.kff.org/report-section/a-national-survey-of-obgyns-experiences-after-dobbs-report/
Care Post-Roe: Documenting cases of poor-quality care since the Dobbs decision, Grossman D., Joffe C., Kaller S., Kimport K., Kinsey E., Lerma K., Morris N, White K, Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, May 2023
The report provides preliminary findings (September 2022-March 2023) of poor-quality healthcare in 14 states that have banned or severely restricted abortion since the Dobbs decision. Health care providers describe case details that deviate from the usual standard of care. The impact is “…increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the healthcare system for people of color.”
The full report is available at: https://www.ansirh.org/research/research/how-post-roe-laws-are-obstructing-clinical-care
The infant mortality rate (IMR), is based upon the yearly number of infant deaths per 1000 live births up to the age of one year. The IMR is one of the best predictors of a country’s life expectancy and is used as an indicator of population health. Pabayo, Roman et al. Laws Restricting Access to Abortion Services and Infant Mortality Risk in the United States, Int. J. Environ. Res. Public Health, May 26, 2020, 17(11), 3773; https://doi.org/10.3390/ijerph17113773
citing Anderson, R.N. A method for constructing complete annual U.S. life tables. Vital Health Stat. 2 2000, 129, 1–28.
2021 US Infant Mortality (IMR): 5.44 deaths per 1,000 live births.
Disparate Impact:
- IMR for infants born to Black mothers had the highest rate of 10.55 per 1,000 live births
- IMR for infants born to Native Pacific or Other Pacific Islander mothers was 7.76 per 1,000 live births
- IMR for infants born to American Indian or Alaska Native mothers was 7.46 per 1,000 live births
- IMR for infants born to Hispanic mothers was 4.79 per 1,000 live births
- IMR for infants born to White mothers was 4.36 per 1,000 live births
- IMR for infants born to Asian mothers was 3.69 per 1,000 live births. (This increased 17% from 2020)
Ely, Danielle, Driscoll, Anne K., Infant Mortality in the United States, 2021: Data from the Period Linked Birth/Infant Death File, National Vital Statistics Reports, Vol. 72, No. 11, September 12, 2023, available at: https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-11.pdf
To view 2021 Infant Mortality Rates by State
See: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
Infant Mortality, Reproductive Health, CDC, Source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion