Differences in Abortion Service Delivery in Hostile, Middle-ground, and Supportive States in 2014

Jones, Rachel K.; Ingerick, Meghan; Jerman, Jenna

doi:10.1016/j.whi.2017.12.003

Cited by 53 publications

(39 citation statements)

References 16 publications

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“…27 The majority of patients obtaining abortions are poor or low-income, many lack health insurance that will cover the procedure, 28 and many live in states with numerous abortion restrictions. 8 These factors, along with the increased accessibility of resources to help individuals safely self-manage their abortions outside of a clinical setting, likely account for some of the decline in abortions that we have documented. However, one national survey of U.S. adult women, conducted in 2017, found that only 1.4% reported ever having attempted to end a pregnancy on their own.…”

Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 92%

“…These declines were steepest in the Midwest and South (22% and 13%, respectively), regions that had also enacted the most abortion restrictions. 8 Still, the 2014 study did not identify a clear association between changes in clinic numbers and state abortion rates between 2011 and 2014; for example, the declines in abortion rates in some states that had lost one-third or more of their clinic facilities mirrored, or were smaller than, the national decline. Updated national data suggest that the overall number of facilities providing abortion did not change much between 2014 1 and 2017, 9 but state and regional patterns of clinic closures may reveal meaningful patterns in availability of and access to services over time.…”

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confidence: 96%

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Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

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146

143

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This study used new data from the Guttmacher Institute to examine trends in abortion incidence and rates between 2014 and 2017. In addition, we examined changes in the number of health care facilities that provide abortions. ■ ■ In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend. ■ ■ The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15-44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country. ■ ■ A total of 339,640 medication abortions occurred in 2017-about 39% of all abortions. ■ ■ As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians' offices and hospitals accounted for 5%. ■ ■ In 2017, 808 clinic facilities provided abortions, a 2% increase from 2014. However, regional and state disparities in clinic availability grew more pronounced; the number of clinics increased in the Northeast and the West, by 16% and 4% respectively, and decreased in the Midwest and the South, by 6% and 9%, respectively. ■ ■ Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates. ■ ■ Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births. ■ ■ Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.

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Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 92%

mentioning

confidence: 96%

Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

Self Cite

146

143

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“…Ten of the top 25 health systems in the US are Catholic, furthermore, one in six beds are now in Catholic hospitals [ 1 ]. The historically non-religious Washington State, deemed a state with a supportive abortion policy environment [ 2 ], has been particularly impacted by this shift, where 34% of the hospitals and 40% of the hospital beds are located in Catholic affiliated hospitals – greater than the national average [ 1 ]. This trend of increasing hospital care falling under Catholic jurisdiction is predicted to continue [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Ambiguities in Washington State hospital policies, irrespective of Catholic affiliation, regarding abortion and contraception service provision

2018

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BackgroundIn 2014, the governor of Washington State mandated that all hospitals publically post a reproductive health policy amidst concerns about the lack of clarity among the public how hospitals handled various aspects of reproductive health care.MethodsThe objective of this study is to assess the clarity of abortion and contraception service provision in the hospital reproductive health policies for the public in Washington State. All Washington State hospital reproductive health policies (n = 88) were analyzed in 2016 using content analysis. Results were stratified by Catholic religious affiliation of the hospital.ResultsThere were more similarities than differences between the non-Catholic and Catholic hospital reproductive health policies; however, there were a few differences. Non-Catholic hospitals were more likely than Catholic hospitals to use legal language (except for emergency contraception), include conscientious clause for providers (44% vs. 0%), and were less likely to specify that emergency contraception use was available for sexual assault victims only (16% vs 54%). Most hospital reproductive health policies, regardless of Catholic affiliation, provided more confusion than clarity in terms of abortion and contraception service provision.ConclusionsThe impact of Catholic, and non-Catholic, affiliated hospital care on patients who need abortion and contraceptive services is concerning. Given the difficulties in meeting the goals of increased transparency for the public through hospital policy language, the government should instead mandate hospitals use a standardized checklist. Additionally, patients are in dire need of positive rights to information about and services to avoid the potential gap in care that the negative rights afforded to providers and facilities to opt-out of providing abortion and contraceptive services have created.

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“…Between 2008 and 2014, U.S. abortion rates fell by about 25%, with declines largest among teens (46%; Jones & Jerman, ). The decrease in abortions is attributable both to less demand (fewer unintended pregnancies) and less supply as a result of the growing number of state‐level restrictions limiting access to abortion (Foster, ; Jones, Ingerick, & Jerman, ). Such restrictions include requirements about physician admitting privileges, mandatory counseling, waiting periods, facility standards, and gestational limits.…”

Section: Levels Trends and Patterns In Childbearingmentioning

confidence: 99%

Pathways to Parenthood in Social and Family Contexts: Decade in Review, 2020

Guzzo

Hayford

2020

J of Marriage and Family

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Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well‐being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors. This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. U.S. fertility has declined in recent years, perhaps reflecting the influence of the Great Recession and increasing economic inequality, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social contexts, but more work is needed to understand group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research has important implications for social policy, but the application of research to policy is hindered by ideological factors.

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Differences in Abortion Service Delivery in Hostile, Middle-ground, and Supportive States in 2014

Cited by 53 publications

References 16 publications

Abortion Incidence and Service Availability in the United States, 2017

Abortion Incidence and Service Availability in the United States, 2017

Ambiguities in Washington State hospital policies, irrespective of Catholic affiliation, regarding abortion and contraception service provision

Pathways to Parenthood in Social and Family Contexts: Decade in Review, 2020

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