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Geographic disparities in disruptions to abortion care in Louisiana at the onset of the COVID-19 pandemic.
Berglas, Nancy F; White, Kari; Schroeder, Rosalyn; Roberts, Sarah C M.
  • Berglas NF; Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA United States. Electronic address: nancy.berglas@ucsf.edu.
  • White K; Texas Policy Evaluation Project, Population Research Center, University of Texas at Austin, Austin, TX, United States.
  • Schroeder R; Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA United States.
  • Roberts SCM; Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA United States.
Contraception ; 115: 17-21, 2022 11.
Article in English | MEDLINE | ID: covidwho-1966462
ABSTRACT

OBJECTIVES:

Prior research identified a significant decline in the number of abortions in Louisiana at the onset of the COVID-19 pandemic, as well as increases in second-trimester abortions and decreases in medication abortions. This study examines how service disruptions in particular areas of the state disparately affected access to abortion care based on geography. STUDY

DESIGN:

We collected monthly service data from Louisiana's abortion clinics (January 2018-May 2020) and conducted mystery client calls to determine whether clinics were scheduling appointments at pandemic onset (April-May 2020). We used segmented regression to assess whether service disruptions modified the main pandemic effects on the number, timing, and type of abortions using stratified models and interaction terms. Additionally, we calculated the median distance that Louisiana residents traveled to the clinic where they obtained care.

RESULTS:

For residents whose closest clinic was consistently scheduling appointments at the onset of the pandemic, the number of monthly abortions did not change (IRR = 1.07, 95% CI 0.84-1.36). For those whose closest clinic services were disrupted, the number of monthly abortions decreased by 46% (IRR = 0.54, 95% CI 0.45-0.65). Similarly, increases in second-trimester abortions and decreases in medication abortions were concentrated in areas where residents experienced service disruptions (AOR = 2.25, 95% CI 1.21-4.56 and AOR = 0.59, 95% CI 0.29-0.87, respectively) and were not seen elsewhere in the state.

CONCLUSION:

Changes in the number, timing and type of abortions were concentrated among residents in particular areas of Louisiana. The early stages of the COVID-19 pandemic exacerbated geographic disparities in access to abortion care. IMPLICATIONS Disruptions in services at the beginning of the COVID-19 pandemic in Louisiana meaningfully affected pregnant people's ability to obtain an abortion at their nearest clinic. These findings reinforce the importance of developing mechanisms to support pregnant people during emergency situations when traveling to a nearby clinic is no longer possible.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Abortion, Induced / Healthcare Disparities / Pandemics / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Pregnancy Country/Region as subject: North America Language: English Journal: Contraception Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Abortion, Induced / Healthcare Disparities / Pandemics / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Pregnancy Country/Region as subject: North America Language: English Journal: Contraception Year: 2022 Document Type: Article