Literature DB >> 32592799

Factors associated with abortion at 12 or more weeks gestation after implementation of a restrictive Texas law.

Vinita Goyal1, Robin Wallace2, Amna I Dermish3, Bhavik Kumar4, Ann Schutt-Ainé4, Anitra Beasley4, Abigail R A Aiken5.   

Abstract

OBJECTIVE: To examine factors associated with obtaining abortion at 12 or more weeks gestation in Texas after implementation of a restrictive law. STUDY
DESIGN: In this retrospective cohort study, we collected data from eight Texas abortion clinics that provided services at 12 or more weeks gestation from April 1, 2015 to March 30, 2016, after a restrictive abortion law enacted in November 2013 shuttered many of the state's clinics. We examined factors associated with obtaining in-clinic abortion services between 3-11 versus 12-24 weeks gestation including patient race-ethnicity, income level, and driving distance to the clinic using chi-square tests and calculating odds ratios. We further subcategorized abortion between 15-24 weeks to determine who may be most affected by a Texas law banning dilation and evacuation (D&E).
RESULTS: Among 24,555 in-clinic abortions, 19.2% (n = 4,714) occurred at 12 or more weeks gestation. Compared to patients who obtained care between 3-11 weeks, those who obtained care at 12 or more weeks were more likely to be Black than White (OR 1.18; 95% CI 1.05-1.31), live ≤110% of the federal poverty level than have higher income (OR 2.09; 95% CI 1.94-2.26), and drive 50+ miles than 1-24 miles to obtain care (OR 1.25; 95% CI 1.15-1.38). These associations remained for those obtaining care between 15-24 weeks. Even after adjusting for race-ethnicity and driving distance, low-income patients had greater odds of obtaining care in between 15-24 weeks (aOR 1.52; 95% CI 1.21-1.91).
CONCLUSIONS: Patients obtaining abortion at 12 or more weeks gestation in Texas are more likely to be Black, low-income, and travel far distances to obtain in-clinic care. IMPLICATIONS: In Texas, patients who are Black, low-income, and travel the farthest are more likely to obtain in-clinic abortion between 15-24 weeks gestation, commonly performed via D&E. If Texas Senate Bill 8 (SB8) banning D&E goes into effect, these patients may be prevented from obtaining care.
Copyright © 2020 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Abortion; Legislative restrictions; Second-trimester abortion; Texas

Year:  2020        PMID: 32592799      PMCID: PMC7606493          DOI: 10.1016/j.contraception.2020.06.007

Source DB:  PubMed          Journal:  Contraception        ISSN: 0010-7824            Impact factor:   3.375


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