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Provision of Medications for Self-Managed Abortion Before and After the Dobbs v Jackson Women's Health Organization Decision.
- Source :
-
JAMA [JAMA] 2024 May 14; Vol. 331 (18), pp. 1558-1564. - Publication Year :
- 2024
-
Abstract
- Importance: The Supreme Court decision in Dobbs v Jackson Women's Health Organization overturned the right to choose abortion in the US, with at least 16 states subsequently implementing abortion bans or 6-week gestational limits. Prior research indicates that in the 6 months following Dobbs, approximately 32 360 fewer abortions were provided within the US formal health care setting. However, trends in the provision of medications for self-managed abortion outside the formal health care setting have not been studied.<br />Objective: To determine whether the provision of medications for self-managed abortion outside the formal health care setting increased in the 6 months after Dobbs.<br />Design, Setting, and Participants: Cross-sectional study using data from sources that provided abortion medications outside the formal health care setting to people in the US between March 1 and December 31, 2022, including online telemedicine organizations, community networks, and online vendors. Using a hierarchical bayesian model, we imputed missing values from sources not providing data. We estimated the change in provision of medications for self-managed abortion after the Dobbs decision. We then estimated actual use of these medications by accounting for the possibility that not all provided medications are used by recipients.<br />Exposure: Abortion restrictions following the Dobbs decision.<br />Main Outcomes and Measures: Provision and use of medications for a self-managed abortion.<br />Results: In the 6-month post-Dobbs period (July 1 to December 31, 2022), the total number of provisions of medications for self-managed abortion increased by 27 838 (95% credible interval [CrI], 26 374-29 175) vs what would have been expected based on pre-Dobbs levels. Excluding imputed data changes the results only slightly (27 145; 95% CrI, 25 747-28 246). Accounting for nonuse of medications, actual self-managed medication abortions increased by an estimated 26 055 (95% CrI, 24 739-27 245) vs what would have been expected had the Dobbs decision not occurred.<br />Conclusions and Relevance: Provision of medications for self-managed abortions increased in the 6 months following the Dobbs decision. Results suggest that a substantial number of abortion seekers accessed services despite the implementation of state-level bans and restrictions.
- Subjects :
- Female
Humans
Pregnancy
Abortion, Legal legislation & jurisprudence
Abortion, Legal methods
Cross-Sectional Studies
Mifepristone supply & distribution
Mifepristone therapeutic use
Misoprostol supply & distribution
Misoprostol therapeutic use
Self Care methods
Self Care trends
United States epidemiology
Abortifacient Agents supply & distribution
Abortifacient Agents therapeutic use
Abortion, Induced legislation & jurisprudence
Abortion, Induced methods
Health Services Accessibility legislation & jurisprudence
Health Services Accessibility statistics & numerical data
Health Services Accessibility trends
Supreme Court Decisions
Subjects
Details
- Language :
- English
- ISSN :
- 1538-3598
- Volume :
- 331
- Issue :
- 18
- Database :
- MEDLINE
- Journal :
- JAMA
- Publication Type :
- Academic Journal
- Accession number :
- 38526865
- Full Text :
- https://doi.org/10.1001/jama.2024.4266