Population Research Center, University of Texas at Austin, Austin, TX, United States.
Southwestern Women's Surgery Center, Dallas, TX, United States.
Contraception. 2020 Nov;102(5):314-317. doi: 10.1016/j.contraception.2020.06.007. Epub 2020 Jun 25.
To examine factors associated with obtaining abortion at 12 or more weeks gestation in Texas after implementation of a restrictive law.
In this retrospective cohort study, we collected data from eight Texas abortion clinics that provided services at 12 or more weeks gestation from April 1, 2015 to March 30, 2016, after a restrictive abortion law enacted in November 2013 shuttered many of the state's clinics. We examined factors associated with obtaining in-clinic abortion services between 3-11 versus 12-24 weeks gestation including patient race-ethnicity, income level, and driving distance to the clinic using chi-square tests and calculating odds ratios. We further subcategorized abortion between 15-24 weeks to determine who may be most affected by a Texas law banning dilation and evacuation (D&E).
Among 24,555 in-clinic abortions, 19.2% (n = 4,714) occurred at 12 or more weeks gestation. Compared to patients who obtained care between 3-11 weeks, those who obtained care at 12 or more weeks were more likely to be Black than White (OR 1.18; 95% CI 1.05-1.31), live ≤110% of the federal poverty level than have higher income (OR 2.09; 95% CI 1.94-2.26), and drive 50+ miles than 1-24 miles to obtain care (OR 1.25; 95% CI 1.15-1.38). These associations remained for those obtaining care between 15-24 weeks. Even after adjusting for race-ethnicity and driving distance, low-income patients had greater odds of obtaining care in between 15-24 weeks (aOR 1.52; 95% CI 1.21-1.91).
Patients obtaining abortion at 12 or more weeks gestation in Texas are more likely to be Black, low-income, and travel far distances to obtain in-clinic care.
In Texas, patients who are Black, low-income, and travel the farthest are more likely to obtain in-clinic abortion between 15-24 weeks gestation, commonly performed via D&E. If Texas Senate Bill 8 (SB8) banning D&E goes into effect, these patients may be prevented from obtaining care.
在德克萨斯州实施一项限制堕胎法后，调查与怀孕 12 周或以上时获得堕胎相关的因素。
在这项回顾性队列研究中，我们收集了 2015 年 4 月 1 日至 2016 年 3 月 30 日期间，在德克萨斯州的八家堕胎诊所提供怀孕 12 周或以上的堕胎服务的数据，这些诊所是在 2013 年 11 月颁布的一项限制堕胎法后关闭的。我们使用卡方检验和计算比值比，检查了在 3-11 周和 12-24 周之间获得门诊堕胎服务的相关因素，包括患者种族、收入水平和到诊所的驾驶距离。我们进一步将堕胎分为 15-24 周，以确定谁可能最受德克萨斯州禁止扩张和排空（D&E）法的影响。
在 24555 例门诊堕胎中，19.2%（n=4714）发生在怀孕 12 周或以上。与在 3-11 周获得护理的患者相比，在 12 周或以上获得护理的患者更有可能是黑人而不是白人（比值比 1.18；95%置信区间 1.05-1.31），收入低于联邦贫困线 110%以下的可能性高于收入较高（比值比 2.09；95%置信区间 1.94-2.26），而且距离诊所 50 英里以上的可能性高于距离诊所 1-24 英里（比值比 1.25；95%置信区间 1.15-1.38）。这些关联在获得 15-24 周护理的患者中仍然存在。即使在调整了种族和驾驶距离后，低收入患者在 15-24 周之间获得护理的可能性也更大（调整比值比 1.52；95%置信区间 1.21-1.91）。
在德克萨斯州，怀孕 12 周或以上时获得堕胎的患者更有可能是黑人、低收入和长途跋涉到诊所获得治疗。
在德克萨斯州，黑人和低收入且距离诊所最远的患者更有可能在 15-24 周之间获得门诊堕胎，通常通过 D&E 进行。如果德克萨斯州参议院法案 8（SB8）禁止 D&E 生效，这些患者可能无法获得护理。
