Guttmacher Institute, New York, New York.
Guttmacher Institute, New York, New York.
Womens Health Issues. 2018 May-Jun;28(3):212-218. doi: 10.1016/j.whi.2017.12.003. Epub 2018 Jan 12.
In 2013, the majority of women lived in states considered hostile to abortion rights, or states with numerous abortion restrictions. By comparison, 31% lived in supportive states. This study examined differences in abortion service delivery according to the policy climate in which clinics must operate.
Data come from the 2014 Abortion Provider Census, which contains information about all known abortion-providing facilities in the United States. In addition to number and type of facility, we examine several aspects of abortion care: provision of only early medication abortion (EMA-only), whether an advanced practice clinician provided abortions, gestational parameters, and average charge for procedure. All indicators were examined nationally and according to whether the clinic was in a state that was hostile, middle ground, or supportive of abortion rights.
In 2014, hostile and supportive states accounted for the same proportion of all U.S. abortions-44% (each)-although 57% of women age 15 to 44 lived in hostile states. Hostile states had one-half as many abortion-providing facilities as supportive ones. EMA-only facilities accounted for 37% of clinics in supportive states compared with 8% in hostile states. Sixty-five percent of clinics in supportive states reported that advanced practice clinicians provided abortion care, compared with 3% in hostile states. After cost of living adjustments, a first-trimester surgical abortion was most expensive in middle-ground states ($470) and least expensive in supportive states ($402).
The distribution of abortion services, the type of facility in which they are provided, and the amount a facility charges all vary according to the abortion policy climate.
2013 年，大多数妇女生活在被认为对堕胎权不友好的州，或堕胎限制较多的州。相比之下，31%的妇女生活在支持堕胎的州。本研究根据诊所必须运作的政策环境，检查堕胎服务提供的差异。
数据来自 2014 年堕胎提供者普查，其中包含了美国所有已知的堕胎提供设施的信息。除了设施的数量和类型外，我们还研究了堕胎护理的几个方面：仅提供早期药物流产（仅 EMA）、是否有高级执业临床医生提供堕胎服务、妊娠参数和手术平均费用。所有指标均在全国范围内以及诊所所在的州是否对堕胎权利持敌对、中立或支持的立场进行了检查。
2014 年，敌对和支持堕胎权利的州占美国所有堕胎的比例相同——各占 44%（尽管 15 至 44 岁的妇女中有 57%生活在敌对州）。敌对州的堕胎服务提供机构数量是支持堕胎权利的州的一半。在支持堕胎权利的州，仅有 EMA 的机构占诊所的 37%，而在敌对州则占 8%。在支持堕胎权利的州，65%的诊所报告说，高级执业临床医生提供堕胎护理，而在敌对州则为 3%。经生活成本调整后，在中间立场州，早期妊娠手术堕胎的费用最高（470 美元），在支持堕胎权利的州则最低（402 美元）。
堕胎服务的分布、提供服务的设施类型以及设施收取的费用都根据堕胎政策环境而有所不同。
