德克萨斯州实施限制堕胎法后妇女获得堕胎护理的体验：一项定性研究。
Women's Experience Obtaining Abortion Care in Texas after Implementation of Restrictive Abortion Laws: A Qualitative Study.
机构信息
Texas Policy Evaluation Project, Austin, Texas, United States of America.
Ibis Reproductive Health, Oakland, California, United States of America.
出版信息
PLoS One. 2016 Oct 26;11(10):e0165048. doi: 10.1371/journal.pone.0165048. eCollection 2016.
BACKGROUND
In November 2013, Texas implemented three abortion restrictions included in House Bill 2 (HB 2). Within six months, the number of facilities providing abortion decreased by almost half, and the remaining facilities were concentrated in large urban centers. The number of medication abortions decreased by 70% compared to the same period one year prior due to restrictions on this method imposed by HB 2. The purpose of this study was to explore qualitatively the experiences of women who were most affected by the law: those who had to travel farther to reach a facility and those desiring medication abortion.
METHODS
In August and September 2014, we conducted 20 in-depth interviews with women recruited from ten abortion clinics across Texas. The purposive sample included women who obtained or strongly preferred medication abortion or traveled ≥50 miles one way to the clinic. The interview guide focused on women's experiences with obtaining services following implementation of HB 2, and a thematic analysis was performed.
RESULTS
Women faced informational, cost and logistical barriers seeking abortion services, and these obstacles were often compounded by poverty. Two women found the process of finding or getting to a clinic so onerous that they considered not having the procedure, although they ultimately had an abortion; another woman decided to continue her pregnancy, in part because of challenges in getting to the clinic. For two women, arranging travel required disclosure to more people than desired. Women who strongly preferred medication abortion were frustrated by the difficulty or inability to obtain their desired method, especially among those who were near or just beyond the gestational age limit. The restricted eligibility criteria for medication abortion and difficulty finding clinics offering the method created substantial access barriers.
CONCLUSIONS
Medication abortion restrictions and clinic closures following HB 2 created substantial barriers for women seeking abortion in Texas.
背景
2013 年 11 月，德克萨斯州实施了三项堕胎限制，这些限制包含在众议院法案 2（HB 2）中。在六个月内，提供堕胎服务的设施数量减少了近一半，剩下的设施集中在大型城市中心。由于 HB 2 对该方法的限制，与前一年同期相比，药物流产的数量减少了 70%。本研究的目的是定性探讨受该法律影响最大的女性的经历：那些不得不长途跋涉前往医疗机构的女性和那些希望进行药物流产的女性。
方法
2014 年 8 月至 9 月，我们从德克萨斯州的十个堕胎诊所招募了 20 名女性进行深入访谈。有目的的样本包括获得或强烈倾向于药物流产或单程旅行≥50 英里前往诊所的女性。访谈指南侧重于女性在 HB 2 实施后获得服务的经验，并进行了主题分析。
结果
女性在寻求堕胎服务时面临信息、成本和后勤方面的障碍，这些障碍往往因贫困而更加复杂。有两名女性发现寻找或到达诊所的过程如此繁琐，以至于她们考虑不进行手术，尽管她们最终还是做了流产；另一名女性决定继续怀孕，部分原因是去诊所的困难。对于两名女性来说，安排旅行需要向比她们希望的更多的人透露信息。强烈倾向于药物流产的女性对难以获得或无法获得她们想要的方法感到沮丧，尤其是那些接近或刚刚超过妊娠年龄限制的女性。药物流产的限制资格标准和寻找提供该方法的诊所的困难造成了实质性的准入障碍。
结论
HB 2 之后的药物流产限制和诊所关闭给德克萨斯州寻求堕胎的女性带来了实质性的障碍。
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