Change in Second-Trimester Abortion After Implementation of a Restrictive State Law.

Authored by ncbi.nlm.nih.gov and submitted by skennedy987

To assess whether indicators of limited access to services explained changes in rates of second-trimester abortion after implementation of a restrictive abortion law in Texas.

We used cross-sectional vital statistics data on abortions performed in Texas before (November 1, 2011-October 31, 2012) and after (November 1, 2013-October 31, 2014) implementation of Texas' abortion law. We conducted monthly mystery client calls for information about abortion facility closures and appointment wait times to calculate distance from women's county of residence to the nearest open Texas facility, the number of open abortion facilities in women's region of residence (facility network size), and days until the next consultation visit. We estimated mixed-effects logistic regression models to assess the association between obtaining abortion care after the law's implementation and having a second-trimester abortion (12 weeks of gestation or more), after adjustment for distance, network size, and wait times.

Overall, 64,902 Texas-resident abortions occurred in the period before the law was introduced and 53,174 occurred after its implementation. After implementation, 14.5% of abortions were performed at 12 weeks of gestation or more, compared with 10.5% before the law (P<.001; unadjusted odds ratio [OR] 1.45; 95% CI 1.40-1.50). Adjusting for distance to the nearest facility and facility network size reduced the odds of having a second-trimester abortion after implementation (OR 1.17; 95% CI 1.10-1.25). Women living 50-99 miles from the nearest facility (vs less than 10 miles) had higher odds of second-trimester abortion (OR 1.24; 95% CI 1.11-1.39), as did women in regions with less than one facility per 250,000 reproductive-aged women compared with women in areas that had 1.5 or more facilities (OR 1.57; 95% CI 1.41-1.75). After implementation, women waited 1 to 14 days for a consultation visit; longer waits were associated with higher odds of second-trimester abortion.

Increases in second-trimester abortion after the law's implementation were due to women having more limited access to abortion services.

wicketcity on May 24th, 2019 at 17:55 UTC »

I worked in a clinic as a health counselor, and I have to say: there is a major CRISIS when it comes to reproductive health education. I was teaching hundreds of women about how their reproductive cycles function, in the first place. I was the person who had to tell them that there is a fertile window in their reproductive cycle called ovulation, only after they had already become pregnant. I even had to teach some of them how a condom works, and obviously way too late.

Why was I tasked with that job, and at the point that it was already too late for them, when HUMAN BIOLOGY should be common knowledge by now? I’m looking directly at abstinence only programs, for this, and have been for a while.

Why are they trying to “mystify” where we all come from, and to our youth?

The only thing I’ve been able to come up with is that they are total idiots, who only know how to govern a population, using forced authority and the denial of scientific fact. I am getting more and more convinced that that’s the truth, and that should really worry us.

Construct_validity on May 24th, 2019 at 16:37 UTC »

It's interesting to look at the change in types of abortions before and after the law.

The total number of abortions went down (64,902 to 53,174 the year after) but that was entirely due to the drop of medication abortions <12 weeks of gestation (17,739 to 4,593). The number of surgical abortions < 12 weeks went slightly up (40,350 to 40,861), all abortions 12-15 weeks went up (5,531 to 5,813) and the number ≥16 weeks went increased dramatically (1,282 to 1,907). Basically, this law just made it harder to get the least invasive procedures (first semester medication interventions).

Additionally, the authors also point out that previous studies reported increased numbers of women traveling out of state for abortions after House Bill 2, which may account for the overall drop of abortions.

AdvicePerson on May 24th, 2019 at 16:02 UTC »

Unfortunately, many laws are based on political optics, not scientificly sound outcomes.