德克萨斯州的边境州堕胎率在众议院法案 2 号通过后上升。
Border-state abortions increased for Texas residents after House Bill 2.
机构信息
Texas Policy Evaluation Project, The University of Texas at Austin, Austin, TX, United States; Department of Obstetrics, Gynecology & Reproductive Sciences, Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, University of California, San Francisco, Oakland, CA, United States.
Texas Policy Evaluation Project, The University of Texas at Austin, Austin, TX, United States; Population Research Center, The University of Texas at Austin, Austin, TX, United States.
出版信息
Contraception. 2021 Sep;104(3):314-318. doi: 10.1016/j.contraception.2021.03.017. Epub 2021 Mar 21.
OBJECTIVES
To assess changes in Texas-resident border-state abortions, medication abortions, and abortions ≥22 weeks from last menstrual period (LMP) before and after implementation of House Bill 2 (HB2) in November 2013 and before and after the US Supreme Court's decision regarding HB2 in June 2016.
STUDY DESIGN
We conducted an interrupted time series analysis using 2012-2017 data on Texas-resident abortions in Arkansas, Louisiana, Oklahoma, and New Mexico. Data on procedure type and gestational age were available only for abortions in New Mexico.
RESULTS
Border states reported 762 Texas-resident abortions in 2012, 1,673 in 2014, and 1,475 in 2017. Texas-resident abortions in all border states nearly doubled following HB2's implementation (incidence rate ratio [IRR]=1.92, 95% CI: 1.67-2.20). Border-state abortions then decreased by 19% after the 2016 US Supreme Court decision, compared to the period prior to the decision and after HB2's implementation (IRR=0.81, 95% CI: 0.73-0.91). From 2012 to 2014, the proportion of Texas-resident abortions in New Mexico that were medication abortion increased from 5% to 20% (p < 0.001) and the proportion that were ≥22 weeks from LMP decreased from 40% to 23% (p < p<0.001). Texas vital statistics undercounted annual out-of-state abortions, reporting only 13%-73% of abortions reported by border-state clinics during the study period.
CONCLUSIONS
HB2 was associated with increases in border-state abortions for Texas residents, including in the number of those ≥22 weeks from LMP. Border-state abortions declined after the Supreme Court ruled HB2 unconstitutional yet remained higher than pre-HB2 levels.
IMPLICATIONS STATEMENT
Abortion restrictions that severely curtail access may result in increases in travel out of state for care. Documenting out-of-state abortions is important for evaluating broader policy impacts and to prepare for future service disruptions. Texas residents may have more limited options for care if border states enact restrictive abortion laws.
目的
评估 2013 年 11 月《众议院法案 2 号》（HB2）颁布前后以及 2016 年 6 月美国最高法院就 HB2 做出裁决前后，得克萨斯州边境州居民的堕胎、药物堕胎以及妊娠≥22 周的堕胎数量的变化。
研究设计
我们对 2012-2017 年阿肯色州、路易斯安那州、俄克拉荷马州和新墨西哥州得克萨斯州居民堕胎的数据进行了中断时间序列分析。只有新墨西哥州提供了关于程序类型和妊娠周数的数据。
结果
边境各州报告 2012 年有 762 例得克萨斯州居民堕胎，2014 年有 1673 例，2017 年有 1475 例。HB2 颁布后，所有边境州的得克萨斯州居民堕胎数量几乎翻了一番（发病率比[IRR] = 1.92，95%可信区间：1.67-2.20）。2016 年美国最高法院裁决后，边境州堕胎数量下降了 19%，与裁决前和 HB2 颁布后的时期相比（IRR = 0.81，95%可信区间：0.73-0.91）。2012 年至 2014 年，新墨西哥州得克萨斯州居民药物堕胎的比例从 5%增加到 20%（p < 0.001），妊娠≥22 周的比例从 40%下降到 23%（p < 0.001）。得克萨斯州人口统计数据低估了州外堕胎数量，仅报告了研究期间边境州诊所报告的堕胎数量的 13%-73%。
结论
HB2 与边境州得克萨斯州居民堕胎数量的增加有关，包括妊娠≥22 周的堕胎数量增加。最高法院裁决 HB2 违宪后，边境州堕胎数量下降，但仍高于 HB2 颁布前的水平。
意义
严重限制堕胎机会的堕胎限制可能导致更多人前往州外寻求堕胎服务。记录州外堕胎数量对于评估更广泛的政策影响和为未来的服务中断做好准备非常重要。如果边境州颁布限制堕胎的法律，得克萨斯州居民的堕胎选择可能会更加有限。
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