Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California; the Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York; and the Pegasus Health Justice Center, Dallas, Texas.
Obstet Gynecol. 2023 Mar 1;141(3):602-607. doi: 10.1097/AOG.0000000000005071. Epub 2023 Feb 2.
To describe experiences with abortion counseling and access in patients with lethal or life-limiting fetal diagnoses in Texas after enactment of Senate Bill 8 (SB8).
In this qualitative study, we interviewed patients who obtained abortions after enactment of SB8, using semi-structured interviews to explore how restrictions affected abortion care. Two researchers coded all transcripts using an inductive technique and analyzed themes in an iterative approach.
We interviewed 16 participants who reported gestational durations from 13 to 29 weeks at the time of abortion. Participants described loss of the therapeutic patient-physician relationship and feelings of isolation while pursuing abortion due to the limitations imposed by SB8. For example, participants felt there was a physician "gag rule" regarding abortion ("the unspoken word of termination"), resulting in the need to find information about pregnancy options outside of the medical community and further highlighting the privilege of financial resources necessary to obtain an abortion on their own. Participants also expressed fears regarding confidentiality with their support systems and clinicians ("I would joke around and say, well don't sue me, but halfway mean it") and personal safety when self-referring for abortion ("…am I making the right choice on where I need to go? Is it safe?").
Abortion restrictions and bans such as SB8 erode the patient-physician relationship, evoking fear and safety concerns during a vulnerable time for those undergoing abortion for lethal or life-limiting fetal diagnoses. They force patients to shoulder the significant burden of understanding pregnancy options and navigating the process of abortion alone, which is likely to have greater effects on those with fewer resources.
描述在德克萨斯州参议院法案 8（SB8）颁布后，患有致命或危及生命的胎儿诊断的患者在堕胎咨询和获得方面的经验。
在这项定性研究中，我们对在 SB8 颁布后获得堕胎的患者进行了半结构化访谈，以探讨这些限制如何影响堕胎护理。两名研究人员使用归纳技术对所有转录本进行编码，并采用迭代方法分析主题。
我们采访了 16 名参与者，他们在堕胎时的妊娠时间从 13 周到 29 周不等。参与者描述了由于 SB8 施加的限制，他们在寻求堕胎时失去了治疗性的医患关系和孤立感。例如，参与者感到医生在堕胎问题上有“禁言令”（“未说出口的终止妊娠”），这导致他们需要在医疗社区之外寻找有关妊娠选择的信息，进一步凸显了自行获得堕胎所需的财务资源的特权。参与者还对他们的支持系统和临床医生的保密性表示担忧（“我会开玩笑说，‘不要起诉我，但半开玩笑地说’”），并对自行堕胎时的人身安全表示担忧（“……我选择的地方是正确的吗？安全吗？”）。
像 SB8 这样的堕胎限制和禁令破坏了医患关系，在那些因致命或危及生命的胎儿诊断而进行堕胎的脆弱时刻引起了恐惧和安全问题。它们迫使患者独自承担了解妊娠选择和堕胎过程的重大负担，这可能对资源较少的患者产生更大的影响。
