Global impacts of Dobbs v. Jackson Women’s Health Organization and abortion regression in the United States

Challenges and opportunities in patients with adult congenital heart disease, a narrative review

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Public health and clinical implications of Dobbs v. Jackson for patients and healthcare providers: A scoping review

INTRODUCTION

On June 24, 2022, the U.S. Supreme Court's decision in Dobbs v. Jackson reversed the precedent set forth by Roe v. Wade, empowering individual states to regulate abortion care. This aftermath of this ruling has given rise to widespread bans, limiting the accessibility of abortion services for patients and impeding providers' ability to deliver a comprehensive spectrum of reproductive health services. Of particular concern is the disproportionate impact on medically underserved groups, further heightening existing social and structural disparities in reproductive health.

METHODS

We conducted a scoping review to broadly evaluate the clinical and public health impact of Dobbs on patients' access to abortion care and related reproductive health services, in addition to the training and clinical practice of healthcare providers. We searched eight bibliographic databases (PubMed, Scopus, Embase, PsycINFO, Google Scholar, Science Direct, JSTOR, and Web of Science) and three preprint servers (medRxiv, bioRxiv, and Europe PMC) using various combinations of keywords related to 'abortion', 'Dobbs', and 'Roe' on March 22, 2023. Four reviewers independently screened the studies based on pre-specified eligibility criteria and one reviewer performed data extraction for pre-identified themes. The search was conducted based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines.

RESULTS

Eighteen studies, comprising 12 peer-reviewed articles and 6 study abstracts, met the inclusion criteria. The studies demonstrated that Dobbs increased demand for contraception, magnified existing travel- and cost-related barriers to access, further polarized views on abortion and complex family planning on social media (e.g., Twitter), and evoked substantial concerns among medical trainees regarding their scope of practice and potential legal repercussions for providing abortion care.

CONCLUSION

In the wake of Dobbs v. Jackson, further public health and clinical interventions are urgently needed to bridge disparities in abortion care and reproductive health, mitigating the deleterious consequences of this emerging public health crisis.

Retaining the perinatal care workforce: Lessons learned from experienced physicians who no longer attend deliveries

OBJECTIVE

To inform policy supporting the retention of family physicians (FPs) in the perinatal care workforce by identifying physician characteristics that are associated with retention.

DATA SOURCES AND STUDY SETTING

We surveyed FPs who had been in practice for at least 11 years and reported attending deliveries as part of their practice.

STUDY DESIGN

We compared the characteristics of FPs who continue to provide perinatal care to those who have ceased and explored their reasons for no longer attending deliveries.

DATA COLLECTION/EXTRACTION METHODS

We estimated a probit regression with the dependent variable: whether the physician currently delivers babies. Open-ended survey responses were analyzed and close-coded using a conceptual content analysis approach.

PRINCIPLE FINDINGS

Of the FPs who received a survey, 1505 (37%) responded. Those who continue attending deliveries were more likely to receive a stipend or be paid per hour/shift in addition to their salary versus those paid a salary (percentage point difference = 13), and less likely to work part-time versus full-time (percentage point difference = -20). Those who ceased attending deliveries cite lifestyle (n = 208), call structure (n = 113), and delivery volume (n = 89) among the reasons for doing so.

CONCLUSIONS

Evidence-based policies aimed at preventing attrition from the perinatal care workforce, which might include targeting compensation models and work-life balance.

Survey of colleges and schools of pharmacy to determine restrictions for teaching, research, and advocacy related to contraception

INTRODUCTION

The pharmacist's role in reproductive health is evolving. Since 46 states allow providers to refuse to provide reproductive health services, it is important to consider whether learning is impacted by institution restrictions on contraception teaching, advocacy, and research.

METHODS

An electronic survey was emailed to deans of all pharmacy schools on the American Association of Colleges of Pharmacy Institutional Membership list with a request to share with faculty teaching women's health content within their curriculum. The survey collected information about contraception teaching, research, and advocacy.

RESULTS

Of 145 schools contacted, 39 (27%) provided complete responses. Of these, 22 (56%) were public, not religiously-affiliated, seven (18%) were private, not religiously-affiliated, six (15%) were private, currently religiously-affiliated, and four were (10%) private, historically religiously-affiliated. All respondents taught hormonal contraception in the required curriculum and 15 (39%) taught miscarriage management/abortifacients. None reported restrictions on contraception teaching or research. One respondent cited an advocacy restriction for contraception methods due to violation of the school's beliefs, and another cited an advocacy restriction for miscarriage management/abortifacients. Respondents noted students expressed ethical questions/concerns about refusing to dispense contraception (59%), dispensing certain contraceptives (54%), dispensing to minors (46%), and dispensing all contraceptives (21%). Additionally, respondents reported pharmacists/faculty expressed ethical questions/concerns about refusing to dispense contraception (31%), dispensing to minors (21%), dispensing certain contraceptives (15%), and all contraceptives (13%).

CONCLUSIONS

Overall, respondents reported no restrictions in contraception teaching and scholarship and minimal advocacy restrictions. Faculty should consider ethical questions/concerns from students, faculty, and pharmacists when teaching this material.

Examining ethno-racial attitudes of the public in Twitter discourses related to the United States Supreme Court Dobbs vs. Jackson Women's Health Organization ruling: A machine learning approach

Background

The decision of the US Supreme Court to repeal Roe vs. Wade sparked significant media attention. Although primarily related to abortion, opinions are divided about how this decision would impact disparities, especially for Black, Indigenous, and people of color. We used advanced natural language processing (NLP) techniques to examine ethno-racial contents in Twitter discourses related to the overturn of Roe vs. Wade.

Methods

We screened approximately 3 million tweets posted to Roe vs. Wade discussions and identified unique tweets in English-language that had mentions related to race, ethnicity, and racism posted between June 24 and July 10, 2022. We performed lexicon-based sentiment analysis to identify sentiment polarity and the emotions expressed in the Twitter discourse and conducted structural topic modeling to identify and examine latent themes.

Results

Of the tweets retrieved, 0.7% (n = 23,044) had mentions related to race, ethnicity, and racism. The overall sentiment polarity was negative (mean = -0.41, SD = 1.48). Approximately 60.0% (n = 12,092) expressed negative sentiments, while 39.0% (n = 81,45) expressed positive sentiments, and 3.0% (n = 619) expressed neutral sentiments. There were 20 latent themes which emerged from the topic model. The predominant topics in the discourses were related to "racial resentment" (topic 2, 11.3%), "human rights" (topic 2, 7.9%), and "socioeconomic disadvantage" (topic 16, 7.4%).

Conclusions

Our study demonstrates wide ranging ethno-racial concerns following the reversal of Roe and supports the need for active surveillance of racial and ethnic disparities in abortion access in the post-Roe era.