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Smith MH, Eggen MB, Prestrud AA, Lafferty-Danner K, Gyuras H, Bessett D, Perkins L. Seeking financial and practical support in an abortion-hostile state: Analysis of abortion fund data in Kentucky, 2014-2021: Analysis of abortion fund data in Kentucky. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 39031677 DOI: 10.1111/psrh.12279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
OBJECTIVES Philanthropic abortion funds are integral to accessing care in the United States, providing both financial and practical assistance. Yet relatively little is known about those who seek these essential services. In this study, we analyzed data from a Kentucky abortion fund to assess characteristics of abortion fund callers. METHODS We analyzed 2014-2021 administrative data from the Kentucky Health Justice Network's (KHJN) Abortion Support Fund and compared them to abortion data from the Kentucky Department for Public Health (KDPH). We analyzed age, race, and pregnancy gestation at calling (KHJN) and abortion (KDPH), and calculated Z-scores and p-values to compare proportions in each category between the two data sources. RESULTS The fund supported 6162 people from 2014 to 2021, when 28,741 people had abortions in Kentucky. Compared with KDPH data, KHJN had a higher percentage of callers who were under age 30, a higher percentage of callers who were Black or another race, and a higher percentage of callers at 14 weeks' gestation or higher. CONCLUSIONS Compared with state data, KHJN supported a higher percentage of young people, people of color, and people at later gestations. These findings support evidence that structurally vulnerable groups are more likely to face barriers to care and that abortion funds provide essential support necessary for reproductive equity.
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Affiliation(s)
- Mikaela H Smith
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Melissa B Eggen
- Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | | | - Kathryn Lafferty-Danner
- Kentucky Health Justice Network, Louisville, Kentucky, USA
- Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Hillary Gyuras
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Lizz Perkins
- Kentucky Health Justice Network, Louisville, Kentucky, USA
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Lerma K, Coplon L, Goyal V. Travel for abortion care: implications for clinical practice. Curr Opin Obstet Gynecol 2023; 35:476-483. [PMID: 37916900 DOI: 10.1097/gco.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Traveling long distances to obtain abortion care due to restrictions and scarce availability is associated with significant obstacles. We review clinical strategies that can facilitate abortion access and outline considerations to ensure person-centered and equitable care. RECENT FINDINGS Establishing a patient's gestational duration prior to travel may be beneficial to ensure they are eligible for their desired abortion method at the preferred facility or to determine if a multiday procedure is required. If a local ultrasound cannot be obtained prior to travel, evidence demonstrates people can generally estimate their gestational duration accurately. If unable to provide care, clinicians should make timely referrals for abortion. Integration of telemedicine into abortion care is safe and well regarded by patients and should be implemented into service delivery where possible to reduce obstacles to care. Routine in-person follow-up care is not necessary. However, for those who want reassurance, formalized pathways to care should be established to ensure people have access to care in their community. To further minimize travel-related burdens, facilities should routinely offer information about funding and practical support, emotional support, and legal resources. SUMMARY There are many opportunities to optimize clinical practice to support those traveling for abortion care.
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Affiliation(s)
- Klaira Lerma
- Population Research Center, The University of Texas at Austin, Austin, Texas
| | - Leah Coplon
- Abortion On Demand, Seattle, Washington, USA
| | - Vinita Goyal
- Population Research Center, The University of Texas at Austin, Austin, Texas
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White K, Leyser-Whalen O, Whitfield B, Dane'el A, Andrea A, Rupani A, Kumar B, Moayedi G. Abortion assistance fund staff and volunteers as patient navigators following an abortion ban in Texas. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2023:10.1363/psrh.12240. [PMID: 37491624 PMCID: PMC10808264 DOI: 10.1363/psrh.12240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
CONTEXT Abortion assistance funds constitute an important part of the healthcare safety net by covering some of abortion patients' out-of-pocket costs. Few studies have examined the other ways abortion assistance fund staff and volunteers support callers who need help obtaining care. METHODS Between June and September 2020, we conducted in-depth interviews with 23 staff and volunteers at 11 local abortion assistance funds that helped Texans seeking abortion care following a March 2020 state executive order that prohibited most abortions. Interviewers explored respondents' experiences with callers whose appointments had been canceled or who traveled out of state and subsequent operational changes. We used both inductive and deductive codes in the thematic analysis. RESULTS Abortion assistance fund staff and volunteers bridged callers' information gaps about the services and financial resources available and helped create plans to secure care that accounted for callers' specific needs. They provided emotional support so callers felt it was possible to overcome logistical hurdles to get an abortion, even if that required out-of-state travel. Respondents described greater collaboration between Texas-based abortion assistance funds and out-of-state organizations to support callers' more complex logistical needs and increased costs. Some callers who encountered multiple barriers to care, including interpersonal violence, were unable to obtain an abortion, even with additional supports. CONCLUSIONS Local abortion assistance funds worked with Texas callers to co-create person-centered plans for care and expanded inter-organization collaborations. Initiatives that bolster local assistance funds' infrastructure and capacity will be needed as the abortion access landscape becomes further restricted and complex.
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Affiliation(s)
- Kari White
- Department of Sociology, Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Ophra Leyser-Whalen
- Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, Texas, USA
| | - Brooke Whitfield
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
| | | | | | | | - Bhavik Kumar
- Planned Parenthood Gulf Coast, Houston, Texas, USA
| | - Ghazaleh Moayedi
- Pegasus Health Justice Center, Texas Equal Access Fund, Dallas, Texas, USA
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Hoopes AJ, Maslowsky J, Baca MA, Goldberg J, Harrison ME, Hwang LY, Romano M, Tebb K, Tyson N, Grubb LK. Elevating the Needs of Minor Adolescents in a Landscape of Reduced Abortion Access in the United States. J Adolesc Health 2022; 71:530-532. [PMID: 36096900 PMCID: PMC10511203 DOI: 10.1016/j.jadohealth.2022.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Andrea J Hoopes
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
| | - Julie Maslowsky
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Melanie A Baca
- Department of Family & Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jessica Goldberg
- If/When/How: Lawyering for Reproductive Justice, Oakland, California
| | - Megan E Harrison
- Division of Adolescent Medicine, CHEO, University of Ottawa, Ottawa, Ontario, Canada
| | - Loris Y Hwang
- Department of Pediatrics, Division of Adolescent & Young Adult Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California
| | - Mary Romano
- Division of Adolescent Medicine/Young Adult Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kathleen Tebb
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Nichole Tyson
- Pediatric and Adolescent Gynecology, Division of Gynecologic Specialties, Stanford University School of Medicine, Palo Alto, California
| | - Laura K Grubb
- Division of Adolescent Medicine, Boston Children's Hospital, Boston, Massachusetts
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Abstract
Although teenage pregnancy rates have decreased over the past 30 years, many adolescents become pregnant every year. It is important for pediatricians to have the ability and the resources to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental counseling that includes the full range of pregnancy options. Counseling includes an unbiased discussion of the adolescent's options to continue or terminate the pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. It is important for pediatricians to be familiar with laws and policies impacting access to abortion care, especially for minor adolescents, as well as laws that seek to limit health care professionals' provision of unbiased pregnancy options counseling and referrals, either for abortion care or continuation of pregnancy in accordance with the adolescent's choice. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling that includes the full range of pregnancy options. Pediatricians should be aware of and oppose policies that restrict their ability to provide pregnant adolescents with unbiased counseling that includes the full range of pregnancy options. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue.
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Baca M, Harrison ME, Grubb L, Hoopes A, Hwang L, Maslowsky J, Romano M, Tebb K, Tyson N. SAHM/NASPAG Statement on Leaked Draft SCOTUS Opinion Regarding Mississippi v Jackson Women's Health. J Pediatr Adolesc Gynecol 2022; 35:417-419. [PMID: 35618232 DOI: 10.1016/j.jpag.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Melanie Baca
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Megan E Harrison
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600.
| | - Laura Grubb
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Andrea Hoopes
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Loris Hwang
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Julie Maslowsky
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Mary Romano
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Kathleen Tebb
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
| | - Nichole Tyson
- Children's Hospital of Eastern Ontario, Pediatrics, 401 Smyth Rd, Ottawa, ON, Canada K1H8L1, Phone: 613 737 7600
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