Dindinger Eva, Coleman-Minahan Kate, Sheeder Jeanelle, Fang Nancy Z
University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, CO, United States.
University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, CO, United States.
Contraception. 2025 Mar;143:110731. doi: 10.1016/j.contraception.2024.110731. Epub 2024 Oct 28.
To assess changes in type of abortion, gestational duration, and changes in the proportion of out-of-state residents at a university-affiliated clinic in Denver, Colorado after Texas passed Senate Bill 8 (SB 8) that banned abortion after embryonic cardiac activity can be detected.
We reviewed records of all visits of patients obtaining an abortion ≤22 weeks and 6 days gestation between January 2019 and June 2022. We created two time periods: before SB 8 (January 2019-August 2021) and after SB 8 (September 2021-June 2022). We assessed changes in type of abortion, gestational duration, and the proportion of out-of-state residents. We determined the odds of a second-trimester abortion (≥13 weeks and 0 day) after SB 8 using logistic regression models adjusted for gravida, parity, age, and the proportion of out-of-state residents.
There were 3844 abortions: 2875 before and 969 after SB 8. Second trimester abortions increased from 16.8% to 24.4% for Colorado residents and from 19.5% to 33.5% for out-of-state residents (p < 0.001). The proportion of patients that were Texas residents increased from 1.2% to 17.7% after SB 8 (p < 0.001). The adjusted odds of a second trimester abortion nearly doubled overall (adjusted odds ratio [aOR] 1.86 95% CI 1.55-2.23) and for Colorado residents (aOR,1.76, 95% CI, 1.44-2.16, respectively), and more than doubled for out-of-state residents (aOR, 2.34, 95% CI,1.53-3.59).
Laws that ban abortion early in pregnancy delay care and increase abortions occurring later in pregnancy, not only for people forced to seek care out of state, but for residents of states with abortion access.
Our data suggests that abortion bans may increase wait times, gestational duration, and force people to travel great distances for care. As more states ban abortion or restrict abortion, surrounding states where abortion is protected may need to meet the needs of those traveling in addition to their in-state residents.
评估在科罗拉多州丹佛市一家大学附属医院诊所，自德克萨斯州通过参议院法案8（SB 8）（该法案禁止在检测到胚胎心脏活动后进行堕胎）后，堕胎类型、妊娠持续时间以及州外居民比例的变化。
我们回顾了2019年1月至2022年6月期间所有妊娠≤22周零6天的堕胎患者就诊记录。我们划分了两个时间段：SB 8之前（2019年1月至2021年8月）和SB 8之后（2021年9月至2022年6月）。我们评估了堕胎类型、妊娠持续时间以及州外居民比例的变化。我们使用经孕次、产次、年龄和州外居民比例调整的逻辑回归模型，确定SB 8之后中期堕胎（≥13周零0天）的几率。
共有3844例堕胎：SB 8之前2875例，之后969例。科罗拉多州居民的中期堕胎率从16.8%增至24.4%，州外居民从19.5%增至33.5%（p<0.001）。SB 8之后，德州居民患者比例从1.2%增至17.7%（p<0.001）。总体而言，中期堕胎的调整几率几乎翻倍（调整优势比[aOR] 1.86，95%置信区间[CI] 1.55 - 2.23），科罗拉多州居民（aOR分别为1.76，95% CI 1.44 - 2.16），州外居民则增加了一倍多（aOR 2.34，95% CI 1.53 - 3.59）。
在妊娠早期禁止堕胎的法律会延迟医疗服务，并增加妊娠后期的堕胎数量，不仅对于被迫到州外寻求医疗服务的人如此，对于有堕胎服务可及性的州的居民也是如此。
我们的数据表明，堕胎禁令可能会增加等待时间、妊娠持续时间，并迫使人们长途跋涉寻求医疗服务。随着更多州禁止堕胎或限制堕胎，周边堕胎受保护的州除了满足本州居民需求外可能还需要满足前来就医者的需求。
