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      Seeking abortion care in Ohio and Texas during the COVID-19 pandemic

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          Abstract

          Objectives

          Political and public health responses to the COVID-19 pandemic changed provision of abortion care and exacerbated existing barriers. We aimed to explore experiences of individuals seeking abortion care in two abortion-restrictive states in the United States where state policies and practice changes disrupted abortion provision during the pandemic.

          Study design

          We conducted 22 semi-structured interviews in Texas (n=10) and Ohio (n=12) to assess how state executive orders limiting abortion, along with other public health guidance and pandemic-related service delivery changes, affected individuals seeking abortion care. We included individuals 18 years and older who contacted a facility for abortion care between March and November 2020. We coded and analyzed interview transcripts using both inductive and deductive approaches.

          Results

          Participants reported obstacles to obtaining their preferred timing and method of abortion. These obstacles placed greater demands on those seeking abortion and resulted in delays in obtaining care for as long as 11 weeks, as well as some being unable to obtain an abortion at all.

          Conclusions

          Political and public health responses to the COVID-19 pandemic exacerbated pre-pandemic exacerbated pre-pandemic barriers and existing restrictions and constrained options for people seeking abortion in Ohio and Texas. Delays were consequential for all participants, regardless of their ultimate ability to obtain an abortion.

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          Most cited references11

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          Disparities in Abortion Rates: A Public Health Approach

          Christine Dehlendorf, Tracy A Weitz, Lisa Harris (2013)
          Article 0 comments Cited 47 times – based on 0 reviews     Review now
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            Women's experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas

            Kari White, Sharon Lebenkoff, Liza Fuentes … (2016)
            In 2013, Texas passed legislation restricting abortion services. Almost half of the state's clinics had closed by April 2014, and there was a 13% decline in abortions in the 6 months after the first portions of the law went into effect, compared to the same period 1 year prior. We aimed to describe women's experiences seeking abortion care shortly after clinics closed and document pregnancy outcomes of women affected by these closures.
            Article 0 comments Cited 42 times – based on 0 reviews     Review now
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              COVID ‐19 and Independent Abortion Providers: Findings from a Rapid‐Response Survey

              Sarah C.M. Roberts, Rosalyn Schroeder, Carole Joffe (2020)
              CONTEXT The ways in which the COVID‐19 pandemic has affected abortion providers and abortion care, and the strategies clinics are adopting to navigate the pandemic, have not been well documented. METHODS In April–May 2020, representatives from 103 independent abortion clinics (i.e., those not affiliated with Planned Parenthood) completed a survey that included close‐ended questions about how the pandemic, the public health response, and designations of abortion as a nonessential service had affected their clinic, as well as open‐ended questions about the pandemic's impact. Analyses were primarily descriptive but included an exploration of regional variation. RESULTS All U.S. regions were represented in the sample. At 51% of clinics, clinicians or staff had been unable to work because of the pandemic or public health responses. Temporary closures were more common among clinics in the South (35%) and Midwest (21%) than in the Northeast and West (5% each). More than half of clinics had canceled or postponed nonabortion services (e.g., general gynecologic care); cancelation or postponement of abortion services was less common (25–38%, depending on type) and again especially prevalent in the South and Midwest. Respondents reported the pandemic had had numerous effects on their clinics, including disrupting their workforce, clinic flow and work practices; increasing expenses; and reducing revenues. State laws (including designations of abortion as nonessential) had exacerbated these difficulties. CONCLUSIONS Although independent abortion clinics have faced considerable challenges from the pandemic, most continued to provide abortion care. Despite this resiliency, additional support may be needed to ensure sustainability of these clinics.
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Contraception
                Journal ID (iso-abbrev): Contraception
                Title: Contraception
                Publisher: Published by Elsevier Inc.
                ISSN (Print): 0010-7824
                ISSN (Electronic): 1879-0518
                Publication date PMC-release: 12 October 2022
                Publication date (Electronic): 12 October 2022
                Affiliations
                [a ]Texas Policy Evaluation Project, University of Texas-Austin, 305 E. 23rd St., Stop G18000, Austin, TX 78712
                [b ]Ohio Policy Evaluation Network, University of Cincinnati, The Ohio State University, 1022 Crosley Tower, PO Box 210378, 172 Cunz Hall, 1841 Neil Avenue, Columbus, Cincinnati OH, 43210
                [c ]College of Public Health, The Ohio State University, 324 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210
                [d ]Population Research Center, University of Texas at Austin, 305 E. 23rd St., Stop G18000, Austin, TX 78712
                [e ]Department of Sociology, University of Cincinnati, 1022 Crosley Tower, PO Box 210378, Cincinnati, OH 45221-0378
                [f ]Department of Women's, Gender & Sexuality Studies, University of Cincinnati, 3410 French Hall West, Cincinnati, OH, 45221
                [g ]Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229
                [h ]Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229
                [i ]Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd., Austin, TX 78712
                Author notes
                [* ]Corresponding author: Dr. Emma Carpenter, The University of Texas at Austin, Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, Texas 78712, United States
                Article
                Publisher Item ID: S0010-7824(22)00381-X
                DOI: 10.1016/j.contraception.2022.09.134
                PMC ID: 9554324
                SO-VID: 9fc9e0df-4a6e-4df0-a33e-0f663070af41
                Copyright © © 2022 Published by Elsevier Inc.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 21 June 2021
                Date revision received : 27 September 2022
                Date accepted : 30 September 2022
                Categories
                Subject: Original Research Article

                Keywords: abortion,abortion restrictions,covid-19,qualitative research,united states
                Data availability:
                Keywords: abortion, abortion restrictions, covid-19, qualitative research, united states

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