Smith Mikaela H, McGowan Michelle, Chakraborty Payal, Hood Robert B, Field Meredith P, Bessett Danielle, Norwood Carolette, Norris Alison H
Division of Epidemiology, The Ohio State University, College of Public Health, Columbus, OH, USA.
Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Lancet Reg Health Am. 2023 Feb 15;19:100441. doi: 10.1016/j.lana.2023.100441. eCollection 2023 Mar.
Since 2010, many US states have passed laws restricting abortion providers' ability to provide care. Such legislation has no demonstrated health benefits and creates inequitable barriers for patients.
To examine how Kentucky's abortion policies coincided with facility closures and abortion utilisation, we conducted a review of state abortion policies from 2010 to 2019 using newspapers and websites. We calculated abortion rates (abortions per 1000 women ages 15-44) by state of residence and provision for Kentucky, the South, and the US using data from the CDC and Kentucky Department of Health. We calculated percentages leaving and from out-of-state, and analysed abortions by race, pregnancy duration, and method.
Of 17 policies passed between 2010 and 2019, ten were enacted, including 20-week and telemedicine bans. One of Kentucky's two abortion facilities closed in 2017. The pooled average abortion rate in Kentucky (4.1) and for Kentuckians (5.8) was lower than national averages (11.8 and 11.1). An average of 38% of Kentuckians left their state for care, compared to 7% nationally. In 2019, the abortion rate in Kentucky was 5.8 times higher for Black patients than White patients (compared to 4.8 times nationally). The majority (62%) of abortions in Kentucky took place at 7-13 weeks' gestation.
Abortions in Kentucky were less frequent than in the South and US. The larger Black-White abortion rate gap reflects race- and class-based structural inequities in healthcare. Without federal protections, abortion access in Kentucky will continue waning.
This study was supported by a philanthropic foundation that makes grants anonymously.
自2010年以来，美国许多州通过了限制堕胎服务提供者提供护理能力的法律。此类立法并未显示出对健康有益，还为患者制造了不公平的障碍。
为了研究肯塔基州的堕胎政策与堕胎机构关闭及堕胎利用率之间的关系，我们利用报纸和网站对2010年至2019年的该州堕胎政策进行了审查。我们使用疾病控制与预防中心（CDC）以及肯塔基州卫生部的数据，按居住州以及肯塔基州、南部地区和美国的情况计算了堕胎率（每1000名15 - 44岁女性中的堕胎数）。我们计算了离开该州以及来自州外的比例，并按种族、怀孕时长和堕胎方式对堕胎情况进行了分析。
在2010年至2019年期间通过的17项政策中，有10项得以颁布，包括20周堕胎禁令和远程医疗禁令。肯塔基州的两家堕胎机构之一于2017年关闭。肯塔基州的综合平均堕胎率（4.1）以及肯塔基州居民的堕胎率（5.8）低于全国平均水平（分别为11.8和11.1）。平均有38%的肯塔基州居民离开本州寻求堕胎护理，而全国这一比例为7%。2019年，肯塔基州黑人患者的堕胎率比白人患者高5.8倍（相比之下，全国为4.8倍）。肯塔基州大多数（62%）堕胎发生在妊娠7至13周。
肯塔基州的堕胎情况比南部地区和美国其他地方更为少见。较大的黑人和白人堕胎率差距反映了医疗保健领域基于种族和阶层的结构性不平等。如果没有联邦层面的保护，肯塔基州的堕胎可及性将持续下降。
本研究由一家匿名提供资助的慈善基金会支持。
