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Objectives Methods Results Conclusion Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID‐19 pandemic in a Brazilian city.This is a cross‐sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%.Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months.The COVID‐19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic. [ABSTRACT FROM AUTHOR]

The Italian Ministry of Health reports annually on activities related to abortion and fertility, providing quantitative data that looks ripe for analysis. Actors ranging from activists to medical providers to European courts have criticised the data as misleading, but the Ministry reports have not changed. In this piece, we bring together different perspectives on this data from inside and outside academia and offer guidance on how it should-and should not-be used in research.In this article, we collect a wide variety of publications ranging from civil society groups' reports to court decisions, academic articles and investigative reporting and harmonise the way they engage with the Italian Ministry of Health's data regarding abortion and particularly conscientious objection.Analyses rooted in the demographic and medical data about abortion seekers, the abortion rates over time, the different methods of abortion, etc are trustworthy and can be used to extrapolate levels of abortion access. This dataset on conscientious objectors systematically undercounts objectors, implying a false equivalence between people who do not object and people who actually work in an abortion service. We recommend that the Ministry report both the number of objectors and the number of medical doctors working in abortion services.The Italian Ministry of Health produces some valuable data about abortion, but conscientious objection is the key feature of abortion access in Italy, and this key datapoint is flawed. The Ministry could improve clarity and increase citizens' trust in government reports by adding data on the number of abortion providers., Competing Interests: Competing interests: The authors declare no competing interests., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Miscarriage and abortion require similar clinical management. Restrictions placed on abortion threaten the quality of miscarriage care, a policy spillover that affects many Americans. We combined vital statistics with life-table parameters to estimate that 1,034,000 miscarriages occur annually, including nearly 400,000 in US states with abortion bans. Attempts to restrict mifepristone access further threaten miscarriage management.

Purpose of Review: Dobbs v Jackson Women's Health Organization revoked the decades-old precedent that pregnancy termination is a constitutional right. This review article explores the research landscape describing the consequences of overturning Roe v Wade for patients and providers., Recent Findings: To date, fourteen states have enforced total bans on abortion, with seven more restricting abortion access to levels not seen since before Roe. Dobbs has had immediate and swift consequences from clinical, social and professional perspectives, with increases in maternal mortality and demand for long-acting and permanent contraception, matched by declines in both access to methotrexate and applications to Obstetrics & Gynecology training programs., Summary: Eighteen million patients now live in states where abortion access is highly if not completely inaccessible. Abortion restrictions have profound implications beyond those desiring pregnancy termination; future research should continue to explore the ways Dobbs has affected clinical care, public health and social practices., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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Over the last decade, activists in Latin America have expanded access to safe abortion through processes of accompaniment. Abortion accompaniment is characterised by activism and community-based strategies to facilitate access to, and safe use of, medication abortion, mainly outside clinical contexts. Drawing on findings from a survey of 515 activists who were part of Accompaniment Collectives in Latin America, this study describes the organisation of these collectives, barriers and facilitators to their activism, and how accompaniers perceive the impact and future of abortion accompaniment. Accompaniment Collectives are organised and flexible and operate in diverse social and legal contexts. The main goals of accompaniment are the normalisation and social decriminalisation of abortion culturally (84%); the social construction of autonomy (79%); and the protection of people's freedom (73%), life (71%) and health (67%). Activists in legally restrictive settings identified limited access to abortion medication (73%) and restrictive laws (71%) as the main barriers to accompaniment, while health care personnel objecting to abortion provision on grounds of conscience was most common in legally permissive settings (64%). Collectives have developed strategies to overcome such barriers to and expanding access to abortion care. Activists expect accompaniment to continue regardless of the legal status of abortion.

Competing Interests: We all contributed to the Criminalized Care: How Louisiana's Abortion Bans Endanger Patients and Clinicians(7) report and MH and PKS contributed to In Clinicians' Own Words: How Abortion Bans Impede Emergency Medical Treatment for Pregnant Patients in Idaho(10) brief. We declare no other competing interests.

Black women, particularly those with low-income, are projected to be the most negatively impacted group following the Supreme Court's overturn of Roe v Wade. It is expected that the rate of increase in live births, as well as the rate of maternal mortality, will be steepest for Black women due to high rates of unmet needs for contraception, unintended pregnancies, poverty, barriers to legal abortion access, and systemic racism. Previous research has shown that the legalization of abortion in 1973 significantly improved educational and employment outcomes for Black women, in particular. The current study seeks to assess the perceptions of predominantly under-resourced Black women following the overturning of Roe v Wade. Eighteen Black women participated in one of five focus groups during the summer of 2022 and shared their reactions to the Supreme Court ruling. Using grounded theory, researchers generated the following themes: sexism via forced births, economic implications, and dangers of banned abortions. Based on participants' concerns resulting from the Roe v Wade overturn, policy implications are provided for improving the following systems: safety net, child welfare, and infant and perinatal mental health care., (© 2023. W. Montague Cobb-NMA Health Institute.)

In September 2021, the Mexican Supreme Court issued a decision disallowing any federal or local judicial authority to indict someone for the offense of voluntary or consensual abortion. This decision also declared unconstitutional penalties imposed on medical personnel who facilitate or assist such procedures. Furthermore, the Court decided that limiting access to abortion in cases of rape to a specific time frame was disproportionate. Later on, in September 2023, the Supreme Court confirmed that absolute criminalization of abortion was unconstitutional and declared that the rule supporting criminalization in the Federal Penal Code was without effects. Consequently, healthcare providers who work in public federal health institutions cannot be criminalized for guaranteeing the right to abortion. This article reviews the reasons advanced by the Supreme Court to guarantee the right of reproductive self-determination, as well as the effects of both decisions beyond the decriminalization of abortion by Mexican federal and state legislatures. The paper also examines the scope and limitations of these rulings and identifies the remaining challenges regarding voluntary abortion procedures in Mexico., (© 2024 International Federation of Gynecology and Obstetrics.)

In Nepal, abortion was legalized in 2002. Yet many women are denied abortion services. Women denied abortion services may either continue their pregnancies or find abortion care elsewhere. However, what is not known is the consequences on women, and their children after accessing abortion services or after being denied abortion services. This comment aims to understand the cause of death of women who sought abortion services between 2019 and 2020 and were enrolled in a longitudinal nationwide study of the consequences of legal abortion access in Nepal. Women were interviewed 6 weeks and every 6 months for 3 years after seeking abortion. During the follow-up interviews, the field research assistants were informed about the death of the clients. Once the death was reported, a trained senior research staff visited the deceased persons house and interviewed family members including husbands, maternal parents or in-laws to explore the cause of death. A total of nine deaths were reported between April 2019 and December 2022. Out of nine deceased women, four received abortions while five of them were initially denial abortion services. The majority of the deaths were due to suicide followed by tuberculosis. None of the deaths were caused by abortion or birth. Keywords: Death; Nepal; reproductive ages; womens health.

Relative to neighboring countries, Zambia has among the most progressive abortion policies, but numerous sociopolitical constraints inhibit knowledge of pregnancy termination rights and access to safe abortion services. Multistage cluster sampling was used to randomly select 1,486 women aged 15-44 years from households in three provinces. We used latent class analysis (LCA) to partition women into discrete groups based on patterns of endorsed support for legalized abortion on six socioeconomic and health conditions. Predictors of probabilistic membership in latent profiles of support for legal abortion services were identified through mixture modeling. A three-class solution of support patterns for legal abortion services emerged from LCA: (1) legal abortion opponents (∼58 percent) opposed legal abortion across scenarios; (2) legal abortion advocates (∼23 percent) universally endorsed legal protections for abortion care; and (3) conditional supporters of legal abortion (∼19 percent) only supported legal abortion in circumstances where the pregnancy threatened the fetus or mother. Advocates and Conditional supporters reported higher exposure to family planning messages compared to opponents. Relative to opponents, advocates were more educated, and Conditional supporters were wealthier. Findings reveal that attitudes towards abortion in Zambia are not monolithic, but women with access to financial/social assets exhibited more receptive attitudes towards legal abortion., (© 2024 The Population Council, Inc.)

Objective: In June 2022, the U.S. Supreme Court released a landmark decision in which they held that the right to abortion is not protected by the U.S. Constitution, ending almost 50 years of federally legal abortion in the United States. Because prior research demonstrates linkages between reproductive health and substance use at multiple socioecological levels, in this special section, we present studies that take a broad scope to understanding how addictive behaviors and reproduction-related behaviors, options, and access to care interrelate across a variety of contexts., Method: In this introduction, the guest editors detail the impetus for this special section, provide a brief overview of the present studies, discuss policy and intervention implications, and suggest future research directions., Results: The five studies presented in this special section span a wide range of populations, methods, and substance use and reproduction-related issues, including reasons for past abortions among women with opioid use disorder, alcohol effects on men's condom use resistance, considerations regarding alcohol-involved rape on implementation of "rape exceptions" to abortion bans, the role of early exposure to substance use and sexual abuse on reproductive health outcomes, and the effects of exposure to abortion-related media coverage on alcohol use intentions following the Supreme Court decision., Conclusions: The studies in this special section highlight the ways in which substance use and reproductive health are inextricably intertwined. Recent and future changes in reproductive health legislation and policy underscore the critical need for continued empirical inquiry into these intersecting public health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: State-level abortion bans in the United States have created a complex legal landscape that forces many prospective patients to travel long distances to access abortion care. The financial strain and logistical difficulties associated with travelling out of state for abortion care may present an insurmountable barrier to some individuals, especially to those with limited resources. Tracking the impact of these abortion bans on travel and housing is crucial for understanding abortion access and economic changes following the Dobbs U.S. Supreme Court decision., Study Design: This study used occupancy data from an average of 2,349,635 (standard deviation = 111,578) U.S. Airbnb listings each month from October 1st, 2020, through April 30th, 2023, to measure the impact of abortion bans on travel for abortion care and the resulting economic effects on regional economies., Methods: The study used a synthetic difference-in-differences design to compare monthly-level occupancy rate data from 1-bedroom entire-place Airbnb rentals within a 30-min driving distance of abortion clinics in states with and without abortion bans., Results: The study found a 1.4 percentage point decrease in occupancy rates of Airbnbs around abortion clinics in states where abortion bans were in effect, demonstrating reductions in Airbnb use in states with bans. In the 6-month period post Dobbs, this decrease translates to 16,548 fewer renters and a $1.87 million loss in revenue for 1-bedroom entire-place Airbnbs within a 30-min catchment area of abortion facilities in states with abortion restrictions., Conclusion: This novel use of Airbnb data provides a unique perspective on measuring demand for abortion and healthcare services and demonstrates the value of this data stream as a tool for understanding economic impacts of health policies., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Context: Women, transgender men, and gender non-binary individuals facing unwanted pregnancy use online resources for abortion information. We sought to determine the informational and emotional needs that those seeking abortion information on Reddit expressed immediately following the Dobbs v. Jackson Women's Health Organization (Dobbs) decision in the United States. Furthermore, we aimed to understand how the Reddit community addressed these needs., Methods: We collected posts on Reddit in the subreddit r/abortion that expressed informational or emotional needs related to the Dobbs decision created between June 24, 2022 and July 24, 2022. We identified posts using keywords including "roe," "rvw," and "trigger law" and then manually reviewed them to ensure relevance. We analyzed posts and their comments using qualitative descriptive analysis., Results: One hundred and ten posts met inclusion criteria. Original posters expressed needs for legal and medical information. Posters also expressed need for logistical support, including help accessing medication abortion, traveling out of state, and financing abortion care, and emotional support in general and resulting from fear of parental disapproval and shame relating to abortion stigma. Although responders to these comments addressed these needs by offering general support, accurate information, and reliable resources, intersecting and emotional needs sometimes went unaddressed., Conclusion: The Dobbs decision caused confusion and panic among abortion seekers requesting guidance on r/abortion, resulting in informational and emotional needs. While the r/abortion community actively addressed needs, inherent limitations of an online forum prevented some original posters from receiving the multifaceted support they needed., (© 2024 University of Ottawa.)

Context: In light of the Dobbs v. Jackson Women's Health Organization decision overturning Roe v. Wade, the number of people who need to travel out of state for abortion is increasing as several states impose abortion bans. Better understanding the characteristics of patients who obtained out-of-state abortions before the decision can provide a reference point for future research and inform efforts to improve abortion access., Methods: We used data from the 2014 Abortion Patient Survey, administered by the Guttmacher Institute, to examine the prevalence and characteristics of patients obtaining nonhospital abortions outside of their state of residence. We examined bivariate and multivariable associations between selected characteristics and obtaining an abortion out of state., Results: Six percent of abortion patients traveled out of state for care. Among patients who obtained their abortion out of state, more than half (56.9%) were non-Hispanic (NH) white, 26.6% were non-Hispanic Black, and 10.2% were Hispanic. Two-fifths (43.9%) resided in the South, one-third (34.3%) resided in the Midwest, 15% resided in the Northeast, and 7% resided in the West. More than one-third (38.2%) had family incomes below 100% of the federal poverty level (FPL), and two-thirds (67.7%) paid out of pocket; only 3% used Medicaid. Profiles of out-of-state abortion patients differed from in-state abortion patients by all characteristics except age. In adjusted analyses, NH Black (adjusted odds ratio [AOR]: 0.76; 95% confidence interval [CI]: 0.61-0.96), NH Asian, South Asian, and Asian Pacific Islander (AOR: 0.37; 95% CI: 0.20-0.67), and Hispanic (AOR: 0.46; 95% CI: 0.33-0.64) patients had lower odds of traveling out of state compared with their NH white counterparts. Compared with those paying for their abortion with private insurance, those who paid out of pocket had higher odds of traveling out of state (AOR: 1.75; 95% CI: 1.29-2.37) and those paying with Medicaid had lower odds (AOR: 0.27; 95% CI: 0.15-0.47)., Conclusion: Given the observed differences by race/ethnicity and method of payment for abortion, people of color and those without resources to pay out of pocket may especially benefit from efforts to support access to abortion care via interstate travel as an increasing number of states ban abortion., (Copyright © 2023 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.)

In 2022, the Supreme Court decision in Dobbs v Jackson Women's Health Organization reneged the Constitutional right to an abortion. Many states now enforce laws that ban abortions. There are significant conflicts between state abortion laws and federal regulations that mandate proper assessment, treatment, and stabilization of patients who present for emergency care. This conflict places physicians in an untenable position when treating patients who have a pregnancy that endangers their life. In states that deem abortion a felony, transfer of these patients can extricate the physician, who is in a difficult position. Currently, it is the only reasonable option for hospitals and physicians who are trapped between conflicting state laws and Emergency Medical Treatment and Labor Act rules and regulations., (Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The Supreme Court of the United States' decision in Dobbs v. Jackson Women's Health Organization in June 2022 overturned Roe v. Wade and ended federal protection of abortion rights. Given the drastic policy changes as a result of the ruling and high exposure to media related to abortion, women opposed to the decision may have experienced distress, which could trigger maladaptive coping strategies, such as alcohol use. The present research examined how consuming abortion-related media in the weeks following the Dobbs decision impacted alcohol use intentions among women of reproductive age residing in the 13 "trigger law" states that immediately restricted abortion access., Method: A sample of 196 women ( M age = 30.52, SD = 6.9) residing in trigger law states answered questions about abortion-related media consumption, views toward the Dobbs ruling, negative affect, and alcohol use intentions., Results: Consuming more abortion-related media predicted higher alcohol use intentions for women who opposed the ruling, but not those who were in favor of abortion restrictions., Conclusions: This timely study provides evidence of how the Dobbs ruling is associated with health ramifications beyond reproduction, yielding insights about how high media exposure to large-scale, distressing events may put those most affected-women of reproductive age in states that enacted new policies restricting abortion access-at risk for alcohol use. Findings highlight an imperative direction for future research as abortion restrictions continue to be spotlighted in U.S. media and state legislatures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: In Romania, although the number of elective abortions (EAB) has decreased, the percentage is still quite high, given the large variety of contraceptive methods and their ease of use. The principal factors that influence the decision of EAB are family, education, and income. Our study aimed to determine to what extent the psychosocial factors had an influence on EAB. Material and Methods: A sociological survey-based study was conducted, including women who presented for abortion on request during the period 2015-2018 at the "Bega" University Clinic of Obstetrics-Gynecology, Timişoara. The study investigated the degree of information and the use of contraceptive methods at the moment of pregnancy’s termination request. The extracted latent constructs were women’s general perception of abortion, emotional involvement regarding the pregnancy, relationship and family context, knowledge about the abortion’s consequences, and social status. A structural equation model of EAB was derived, describing the direct (and indirect) effects among latent variables. Results: The EAB model showed significantly adequate fit (χ²(45)=382.262, GFI (Goodness-of-fit index) =0.91, CFI (Comparative Fit Index) =0.951, RMSEA (Root Mean Square Error of Approximation) =0.03, and p<0.001). The model also showed adequate fit with significant indirect effects on EAB of general perception of abortion (β=1.132, p=0.004), emotional involvement regarding the pregnancy (β=0.036, p=0.492), knowledge about abortion consequences (β=0.184, p=0.001), relation and family context (β=0.268, p=0.034), and social status (β=0.061, p=0.422). Conclusions: Results support the use of structural equation modeling for investigating the moderating and mediating effects, while simultaneously measuring latent constructs. Also, results showed that five main factors have an infleunce on EAB. [ABSTRACT FROM AUTHOR]

• A primigravida from a state of the USA with limited abortion access. • Parturient traveled to another state for the legal abortion of an anencephalic fetus. • It was not known she also had a cornual ectopic pregnancy. • Delivery resulted in uterine rupture and cesarean hysterectomy. • Significant morbidity may have occurred had the patient remained in her home state. In the changing legal environment of obstetric care in the USA, with laws in many states banning termination at all stages of pregnancy with narrow exemptions, healthcare providers are encountering cases in which risk to maternal safety is increased. This report presents a case of a 28-year-old primigravida with an anencephalic fetus who was legally unable to pursue termination in her home state. She traveled to another state in order to pursue safe and legal abortion of a non-viable fetus. Due to an unrecognized cornual ectopic gestation, the delivery resulted in uterine rupture, the need for hysterectomy, and significant morbidity in a patient with a strong desire for future fertility. [ABSTRACT FROM AUTHOR]

Introduction: In Romania, an increasing number of women are opting for abortion on demand, despite the large variety of contraceptive methods and their ease of use. Some of the factors that influence the decision of undergoing abortion are family, education and income. The aim of our study was to observe to what extent psychosocial factors had an influence on the decision of abortion on demand (DoAoD). Material and methods: Data were measured during a sociological survey-based study, including 603 patients who presented for abortion on request during the period 2015-2018 at the "Bega" University Clinic of Obstetrics-Gynecology, Timisoara. The study investigated the degree of information and use of contraceptive methods at the moment of pregnancy’s termination request. Based on measured data, the considered latent constructs were women’s general perception of abortion, emotional involvement regarding the pregnancy, relationship and family context, knowledge about the abortion’s consequences, and social status. A structural model was derived, describing the direct (and indirect) effects among latent variables. Results: The DoAoD model showed significantly adequate fit (χ2/df=1.53, GFI=0.91, CFI=0.98, RMSEA=0.05, and p

This paper offers a qualified defence of physician non-compliance with antiabortion legislation in the wake of the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization. The paper examines two ethically troubling trends of post-Dobbs legislation: narrow and vague maternal health exemption clauses and mandatory reporting of miscarriages in jurisdictions where patients may criminal prosecution for medically induced abortions. It then examines and defends a professional obligation on the part of physicians to comply with the law. This obligation, however, is defeasible. The paper then argues that physicians' obligations to comply with the law is defeated when the law is illegitimate and following the law would constitute bad medical practice. Finally, it argues that the ethically troubling trends in post-Dobbs antiabortion legislation may meet these criteria., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To assess changes in the monthly numbers of hospital-based abortions and outpatient early medical abortions in Victoria during January 2012 - March 2022, with a particular interest in the impact of the coronavirus disease 2019 (COVID-19) pandemic., Study Design: Population-based retrospective cohort study; time series analysis of Victorian Admitted Episodes Dataset (VAED) and Pharmaceutical Benefits Scheme (PBS) data., Setting, Participants: All admitted care episodes in Victoria during 1 January 2012 - 31 March 2022 with medical abortion as the principal diagnosis; all PBS claims for mifepristone-misoprostol (MS-2 Step) during 1 January 2015 (date of listing) - 31 March 2022., Main Outcome Measures: Changes in monthly numbers (with 95% confidence intervals [CIs]) of admissions for hospital-based and outpatient early medical abortions during the pre-pandemic period (January 2012 - March 2020), the first full month of the COVID-19 pandemic (April 2020), and the pandemic period (May 2020 - March 2022)., Results: The monthly number of hospital-based abortions declined in Victoria during the pre-pandemic period (slope, -2.92 [95% CI, -3.45 to -2.38] per month); the rate of decline was greater during the pandemic period (slope, -5.74 [95% CI, -10.5 to -0.96] per month). The monthly number of outpatient early medical abortions increased during the pre-pandemic period (slope, 5.94 [95% CI, 5.34-6.34] per month); it declined during the first month of the pandemic (slope, -26.4 [95% CI, -70.1 to -17.3] per month), but did not significantly change thereafter. The total monthly number of abortions during the pandemic period did not deviate markedly from the pre-pandemic median value. The pre-pandemic declines in monthly numbers of abortions in major city hospitals, in private hospitals, or at earlier than 14 weeks' gestation intensified during the pandemic period. During January 2015 - March 2020, 14 634 of 103 496 abortions were outpatient medical abortions (14%); during the pandemic period, 11 154 of 33 056 abortions were outpatient medical abortions (33%)., Conclusions: The use of outpatient early medical abortion has steadily increased in Victoria since the PBS listing of mifepristone-misoprostol, which helped ensure access to abortion during the COVID-19 pandemic. Outpatient medical abortions may eventually outnumber surgical early abortions in Victoria, but they are not always appropriate: hospitals will continue to be essential for comprehensive abortion care., (© 2024 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)