Riley Taylor, Fiastro Anna E, Willerford Amy, Benson Lyndsey S, Godfrey Emily M, Prager Sarah
Department of Epidemiology, University of Washington, Seattle, WA, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Family Medicine, University of Washington, Seattle, WA, USA.
Sex Reprod Healthc. 2025 Mar;43:101069. doi: 10.1016/j.srhc.2025.101069. Epub 2025 Jan 16.
To examine abortion care in the largest academic medical center in Washington, a state protective of abortion rights, before and after the Supreme Court Dobbs decision.
This retrospective cohort study evaluated abortion provision at the University of Washington between January 1, 2022 and October 31, 2023. Data on patient sociodemographic and clinical characteristics were extracted from electronic medical records. We assessed differences in patient sociodemographics, clinical characteristics, and type of care (medication vs. procedural) comparing the pre-Dobbs (January 1, 2022- June 23, 2022) and post-Dobbs (June 24, 2022 - October 31, 2023) periods using chi-squared tests for categorical variables and t-tests for continuous variables.
Among the 494 abortions performed during the study period, most were procedural (63%) and performed in the hospital setting (68%), over one-third (37%) had a fetal anomaly, and 4% were among individuals from out of state. The distribution of gestational duration was bimodal: over one-third of abortions occurred at less than 8 weeks gestation (34%) and 38% were 18 weeks or greater. The weekly number of abortions remained stable and there were minimal significant differences in patient characteristics or type of care comparing the pre-and-post Dobbs periods.
Academic medical centers provide comprehensive abortion services that span primary to complex specialty care. The minimal changes in abortion care following Dobbs suggests academic medical centers have important patient care and training opportunities to expand abortion access in Washington state.
在最高法院做出多布斯裁决前后，对华盛顿州最大的学术医疗中心（该州保护堕胎权利）的堕胎护理情况进行研究。
这项回顾性队列研究评估了2022年1月1日至2023年10月31日期间华盛顿大学的堕胎服务情况。从电子病历中提取患者社会人口统计学和临床特征数据。我们使用卡方检验分析分类变量，使用t检验分析连续变量，比较多布斯裁决前（2022年1月1日至2022年6月23日）和多布斯裁决后（2022年6月24日至2023年10月31日）期间患者的社会人口统计学、临床特征及护理类型（药物流产与手术流产）的差异。
在研究期间进行的494例堕胎手术中，大多数为手术流产（63%），且在医院进行（68%），超过三分之一（37%）的胎儿存在异常，4%的患者来自其他州。孕周分布呈双峰型：超过三分之一的堕胎发生在妊娠8周以内（34%），38%发生在妊娠18周及以上。每周堕胎数量保持稳定，多布斯裁决前后患者特征或护理类型的显著差异极小。
学术医疗中心提供从初级到复杂专科护理的全面堕胎服务。多布斯裁决后堕胎护理的微小变化表明，学术医疗中心在华盛顿州有重要的患者护理和培训机会来扩大堕胎服务的可及性。
