Biggs M Antonia, Schroeder Rosalyn, Kaller Shelly, Grossman Daniel, Scott Karen A, Ralph Lauren J
Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland.
Birthing Cultural Rigor, LLC, Nashville, Tennessee.
JAMA Netw Open. 2025 Jan 2;8(1):e2454767. doi: 10.1001/jamanetworkopen.2024.54767.
Since Dobbs v Jackson Women's Health Organization (Dobbs) removed federal abortion protections, people's views about alternative models of abortion care may have been impacted, yet research on this topic is limited.
To examine changes in national support for and personal interest in advance provision (AP) and over-the-counter (OTC) access to medication abortion.
DESIGN, SETTING, AND PARTICIPANTS: Two nationally representative cross-sectional online surveys were administered to a market research firm's panel members who were assigned female at birth (AFAB) and aged 15 to 49 years from December 2021 to January 2022 (before Dobbs) and June to July 2023 (after Dobbs). Data were analyzed from February 2023 to June 2024.
Completion of survey before and after Dobbs.
Changes from before to after Dobbs in 4 primary outcome measures were examined: support for and personal interest in AP and OTC access to medication abortion.
A total of 6982 AFAB people before Dobbs and 3561 after Dobbs completed at least 1 of 4 primary outcome measures. From before to after Dobbs, 2666 (weighted 31.3%) and 1258 (weighted 30.1%) were aged 30 to 39 years, 1395 (21.4%) and 708 (21.5%) reported their race and ethnicity as Hispanic/Latinx, 594 (13.7%) and 304 (13.6%) as Black non-Hispanic/Latinx, and 4504 (54.6%) and 2270 (54.2%) as White non-Hispanic/Latinx. There was a significant increase from before to after Dobbs in national support for AP (48.9% before; 95% CI, 47.1% to 50.6%; 55.1% after; 95% CI, 52.8% to 57.3%) and OTC access (49.4% before; 95% CI, 47.6% to 51.1%; 55.2% after; 95% CI, 52.9% to 57.5%) and an increase in personal interest in AP (23.6% before; 95% CI, 22.2% to 25.1%; 26.4% after; 95% CI, 24.3% to 28.4%) and OTC access (36.0% before; 95% CI, 34.3% to 37.6%; 42.5% after; 95% CI, 40.2% to 44.7%). Among people living in states with abortion bans, larger increases in personal interest in AP (5.3 percentage points [pp]; 95% CI, 0.5 to 10.3 pp) and OTC access (9.4 pp; 95% CI, 3.9 to 14.9 pp) were observed than among people in states without bans (1.4 pp; 95% CI, -1.7 to 4.6 pp and 5.4 pp; 95% CI, 2.0 to 8.9 pp, respectively).
In this serial cross-sectional analysis of people aged 15 to 49 years before Dobbs and 1 year after Dobbs, findings suggested that national support for expanded access to medication abortion has grown. Alternative models of care, such as AP and OTC, have the potential to offer a promising approach to abortion care, particularly for people living in abortion-restricted states.
自多布斯诉杰克逊妇女健康组织案（多布斯案）取消联邦堕胎保护措施以来，人们对堕胎护理替代模式的看法可能受到了影响，但关于这一主题的研究有限。
研究全国对提前备药（AP）和非处方（OTC）获取药物流产的支持率及个人兴趣的变化。
设计、背景和参与者：对一家市场研究公司的面板成员进行了两次具有全国代表性的横断面在线调查，这些成员出生时被指定为女性（AFAB），年龄在15至49岁之间，调查时间分别为2021年12月至2022年1月（多布斯案之前）和2023年6月至7月（多布斯案之后）。数据于2023年2月至2024年6月进行分析。
在多布斯案前后完成调查。
研究了多布斯案前后4项主要结局指标的变化：对AP和OTC获取药物流产的支持率及个人兴趣。
多布斯案之前有6982名AFAB人群，之后有3561名AFAB人群完成了4项主要结局指标中的至少1项。从多布斯案之前到之后，年龄在30至39岁的分别有2666人（加权后为31.3%）和1258人（加权后为30.1%），将自己的种族和族裔报告为西班牙裔/拉丁裔的分别有1395人（21.4%）和708人（21.5%），报告为非西班牙裔/拉丁裔黑人的分别有594人（13.7%）和304人（13.6%），报告为非西班牙裔/拉丁裔白人 的分别有4504人（54.6%）和2270人（54.2%）。多布斯案之后，全国对AP的支持率（之前为48.9%；95%CI，47.1%至50.6%；之后为55.1%；95%CI，52.8%至57.）和OTC获取的支持率（之前为49.4%；95%CI，47.6%至51.1%；之后为55.2%；95%CI，52.9%至57.5%）显著上升，对AP的个人兴趣（之前为23.6%；95%CI，22.2%至25.1%；之后为26.4%；95%CI，24.3%至28.4%）和OTC获取的个人兴趣（之前为36.0%；95%CI，34.3%至37.6%；之后为42.5%；95%CI，40.2%至44.7%）也有所增加。在有堕胎禁令的州的人群中，对AP的个人兴趣（5.3个百分点[pp]；95%CI，0.5至10.3 pp）和OTC获取的个人兴趣（9.4 pp；95%CI，3.9至14.9 pp）的增幅大于没有禁令的州的人群（分别为1.4 pp；95%CI，-1.7至4.6 pp和5.4 pp；95%CI，2.0至8.9 pp）。
在这项对多布斯案之前15至49岁人群以及多布斯案之后1年人群的系列横断面分析中，研究结果表明全国对扩大药物流产获取途径的支持有所增加。AP和OTC等替代护理模式有可能为堕胎护理提供一种有前景的方法，特别是对于生活在堕胎受限州的人群。
