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Heggie C, Tong L, Heran A, Bhambhani I, McKibbon S, Paynter M. The role of doulas and community birth workers in abortion and contraception care: An international scoping review. Contraception 2024; 136:110482. [PMID: 38734230 DOI: 10.1016/j.contraception.2024.110482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Equitable and safe access to abortion and contraception is essential to protecting reproductive autonomy. Despite this, barriers to access remain. Nonclinical support people, may be able to facilitate access to abortion and contraception services and care, but evidence on the scope and efficacy of doulas in abortion and contraception care is lacking. The aim of this scoping review was to synthesize what is known about the role of doulas in abortion and contraception care. STUDY DESIGN We followed the Joanna Briggs Institute methodology for scoping reviews. A clinical librarian performed an initial search of all relevant databases. Three reviewers independently screened the titles and abstracts for assessment against the inclusion and exclusion criteria. The populations of interest included doulas, and/or untrained birth attendants and birth companions, and patients who use doula services. The concept of interest was the doula and the context was access to abortion or contraception. RESULTS Our review identified relevant studies conducted in different countries, published between 1976 and 2023. Studies broadly focused on three key themes: doulas performing procedural abortions, doulas supporting abortion care, and doulas supporting contraception. Outcomes of interest included client outcomes, barriers to access, doula training, and attitudes. CONCLUSIONS Doulas have the potential to improve client satisfaction and mitigate barriers to accessing abortion and contraception services. Further research is needed to identify the training needs of doulas, the potential for their integration into interdisciplinary care teams, and the role in supporting medication abortion.
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Affiliation(s)
- Clare Heggie
- University of New Brunswick Department of Interdisciplinary Studies, Fredericton, New Brunswick, Canada.
| | - Lin Tong
- University of New Brunswick Faculty of Nursing, Fredericton, New Brunswick, Canada
| | - Aishwarya Heran
- Department of Physiology, McGill University Faculty of Science, Montreal, Quebec, Canada
| | - Ishika Bhambhani
- University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Shelley McKibbon
- Dalhousie University WK Kellogg Health Sciences Library, Halifax, Nova Scotia, Canada
| | - Martha Paynter
- University of New Brunswick Faculty of Nursing, Fredericton, New Brunswick, Canada
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Masters GA, Julce C, Carroll S, Person SD, Allison J, Byatt N, Moore Simas TA. Association of perinatal depression and postpartum contraception intent, choice, and actual use. Contraception 2024; 135:110447. [PMID: 38583583 DOI: 10.1016/j.contraception.2024.110447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES Depression is common during pregnancy and the year following childbirth (the perinatal period). This study assessed the association of depressive symptoms and contraception decisions in perinatal individuals. STUDY DESIGN We conducted a secondary analysis using data from the PRogram in Support of Moms (PRISM) study, a cluster randomized controlled trial of active interventions which aimed to address perinatal depression. This analysis included 191 individuals aged 18-45 who screened positive for depression on the Edinburgh Postnatal Depression Scale (EPDS, score ≥10) during pregnancy or up to 3 months postpartum. We assessed contraception intent and method choice at 1-3 months postpartum. At 5-7 months postpartum, we assessed contraceptive method used and EPDS depression scores. We used logistic regressions to examine the relationship between depression and contraceptive use/method. RESULTS At 1-3 months postpartum, the majority of participants (76.4%) expressed an intention to use contraception. Of those, over half (53.4%) indicated a preference for higher effectiveness contraception methods. Participants with persistent depression symptoms (positive EPDS) at 5-7 months were significantly less likely to report using higher effectiveness contraceptive methods (aOR = 0.28, 95% CI = 0.11-0.70) compared to those without. Among participants with persistent depressive symptoms, 21.1% reported using a contraception method of lower effectiveness than had originally intended. CONCLUSION Perinatal individuals with persistent depressive symptoms at 5-7 months postpartum reported greater use of less-effective contraception methods than originally planned. IMPLICATIONS We found associations between perinatal depression and use of less effective contraception use. Provider discussions regarding contraception planning is important, particularly in those with perinatal depression symptoms.
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Affiliation(s)
- Grace A Masters
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Clevanne Julce
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Smita Carroll
- Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY, USA
| | - Sharina D Person
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Jeroan Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Nancy Byatt
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Psychiatry, UMass Memorial Health, Worcester, MA, USA; Department of Population and Quantitative Health Sciences, UMass Memorial Health, Worcester, MA, USA; Department of Obstetrics and Gynecology, UMass Memorial Health, Worcester, MA, USA
| | - Tiffany A Moore Simas
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Psychiatry, UMass Memorial Health, Worcester, MA, USA; Department of Population and Quantitative Health Sciences, UMass Memorial Health, Worcester, MA, USA; Department of Obstetrics and Gynecology, UMass Memorial Health, Worcester, MA, USA; Department of Pediatrics, UMass Memorial Health, Worcester, MA, USA
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Dieguez RSM, Cabral CDS. Law n. 22,537/2024 of the State of Goiás, Brazil, on awareness against abortion: a critical analysis. CAD SAUDE PUBLICA 2024; 40:e00016724. [PMID: 38922220 PMCID: PMC11192571 DOI: 10.1590/0102-311xen016724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 06/27/2024] Open
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Eick SM, Eatman JA, Chandler M, Brooks NR. Reproductive and Social Policies, Sociopolitical Stress, and Implications for Maternal and Child Health Equity. Curr Environ Health Rep 2024; 11:279-287. [PMID: 38639910 DOI: 10.1007/s40572-024-00443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE OF REVIEW Although many environmental exposures (e.g., air pollution) are geographically patterned and persist as a result of historic economic policies (e.g., redlining), the impact of reproductive and social policies on maternal and child health remains incompletely understood. Reproductive and social policies are increasingly important for maternal and child health equity, particularly following the 2022 US Supreme Court decision in Dobbs v Jackson Women's Health Organization ("Dobbs decision"), which restricted access to abortion. Here, we summarize the literature from original research studies examining influences of reproductive and social policy on maternal and child health, focusing on impacts on adverse birth outcomes and policies as sources of stress. RECENT FINDINGS Several studies suggest that those most impacted by the Dobbs decision are younger, non-white, socioeconomically disadvantaged, and living in states with less access to government safety net programs, all of which are compounded by environmental injustices. Further, studies conducted in the wake of the Dobbs decision find elevated stress levels among women of reproductive age. This may represent one pathway leading to adverse birth outcomes, as epidemiologic studies demonstrate that preterm birth rates increased following the 2016 election, a period of heightened stress. Reproductive and social policies are understudied contributors to adverse outcomes for reproductive-aged women and their children. This has important implications for maternal and child health equity, as those who will be the most impacted by reproductive and social policies already experience the highest rates of adverse birth outcomes and environmental toxicant exposure.
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Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Jasmin A Eatman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
- School of Medicine, Emory University, Atlanta, GA, USA
| | - Madeline Chandler
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nina R Brooks
- Department of Global Health, School of Public Health, Boston University, Boston, MA, USA
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5
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Covvey JR, Bratberg JP. Actions speak louder than words: Taking a stand for reproductive health care and gender-affirming care. J Am Pharm Assoc (2003) 2024; 64:174-178. [PMID: 38309786 DOI: 10.1016/j.japh.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 02/05/2024]
Affiliation(s)
- Jordan R Covvey
- Associate Professor, Duquesne University School of Pharmacy, Pittsburgh, PA
| | - Jeffrey P Bratberg
- Clinical Professor, University of Rhode Island College of Pharmacy, Kingston, RI
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Seymour JW, Goode BA, Guerrero P, Campos AM, Kyles K, Dreyfus-Pai P, Baum SE. Emotional, informational, and decision-making support needs among people seeking abortion in the US: perspectives from All-Options Talkline callers. Sex Reprod Health Matters 2023; 31:2248742. [PMID: 37728428 PMCID: PMC10512898 DOI: 10.1080/26410397.2023.2248742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
People seeking abortion may need or want emotional or informational support before, during, and after their abortion. Feeling supported and affirmed contributes to perceptions of quality care. The All-Options Talkline offers free, telephone-based, peer counselling to callers anywhere in the United States. This study aimed to explore the types of support received through the Talkline and the ways it supplemented other forms of support received by people who obtained an abortion. Between May 2021 and February 2022, we conducted 30 interviews via telephone or Zoom with callers recruited through the Talkline. We coded the interviews and conducted thematic analysis, focusing on themes related to gaps of support from family, friends, and healthcare professionals, as well as types of support received through the Talkline. We identified four key motivations for calling the Talkline, including the need for (1) decision-making support and validation, (2) a neutral perspective, (3) emotional support to discuss negative or complex feelings, and (4) information about the abortion process. Participants indicated that interactions with family, friends, and healthcare professionals ranged from unsupportive and negative, to substantially supportive. Access to the Talkline was particularly useful prior to clinical interactions and in the weeks or months after an abortion. We found that the All-Options Talkline provided person-centred, remote support for callers, filling gaps or supplementing support from one's community or healthcare professionals. Abortion support from non-medically trained support people contributes to high-quality abortion care, especially in a time of increasing abortion restrictions and use of remote abortion services.
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Affiliation(s)
- Jane W. Seymour
- Research Scientist, Collaborative for Reproductive Equity (CORE), Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Bria A. Goode
- Senior Research Manager, Ibis Reproductive Health, Oakland, CA, USA
| | | | | | - Kai Kyles
- Project Coordinator, All-Options, Cleveland, OH, USA
| | | | - Sarah E. Baum
- Senior Research Scientist, Ibis Reproductive Health, Oakland, CA, USA
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7
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Downey MM, Daniel C, McGlynn-Wright A, Haugeberg K. Protect and Control: Coverture's Logics Across Welfare Policy and Abortion Law. PSYCHOLOGY OF WOMEN QUARTERLY 2023; 47:478-493. [PMID: 38606316 PMCID: PMC11008606 DOI: 10.1177/03616843231186320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
In the aftermath of Dobbs v. Jackson Women's Health Organization, which overturned the federal constitutional right to abortion, states have begun to recriminalize the procedure. These abortion bans raise important questions about the political and social status of women and pregnant people in the United States. Moreover, restrictions in social welfare programs such as the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children and Temporary Assistance for Needy Families, which serve low-income pregnant people and parents, raise similar questions. The regulation and administration of all three are framed by race, class, and gender. To understand how these restrictions (a) claim to protect women but ultimately function to control, police, and surveil and (b) rely on imagined, stereotype-laden psychological states such as vulnerability, irresponsibility, or irrationality, we turn to the British Common Law doctrine of coverture, which subsumed a married woman's legal, financial, and political identities under her husband's. The American colonies, and later, states of the United States, drew from British Common Law to craft laws that regulated relationships between men and women. Taken together, this analysis can provide a more comprehensive accounting of the cumulative harms experienced by women, poor people, people of color, and pregnant people in today's health and social welfare landscape. We conclude with recommendations for psychologists and other mental health providers to address, in practice and advocacy, the ethical dilemmas and obligations raised by the reach of coverture's logics in people's lives.
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Affiliation(s)
| | - Clare Daniel
- Newcomb Institute, Tulane University, New Orleans,
USA
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Reeves JA, Goedken P, Hall KS, Lee SC, Cwiak CA. Southeastern US anesthesia providers' perspectives on abortion provision: Inductive findings from a qualitative study. Contraception 2023; 124:110058. [PMID: 37164148 DOI: 10.1016/j.contraception.2023.110058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Health care providers, including anesthesia providers, hold varied personal views on abortion, which influences their involvement in multidisciplinary abortion care. We aimed to explore Southeastern US anesthesia providers' perspectives on abortion provision and factors impacting their decision to provide anesthesia for hospital-based induced abortion. STUDY DESIGN We conducted in-depth, individual interviews with currently practicing anesthesia providers in the Southeastern United States. We recruited participants from regional anesthesiology conferences and via snowball sampling. A semistructured interview guide explored domains of obstetric experiences, standardized abortion cases, and personal abortion attitudes. We coded data iteratively and analyzed data thematically using inductive approaches with qualitative software. RESULTS Fifteen participants completed interviews, at which point thematic saturation occurred. Participants represented a range of provider type and prior abortion experience. Participants weighed "personal and professional viewpoints" in considering their willingness to provide anesthesia care for hospital-based abortion. Many participants who personally disagreed with some abortion indications were still willing to provide anesthesia in those cases, some implicitly naming principles of medical ethics to justify differing professional and personal opinions. Participants also considered their "role in abortion decision-making": all participants reported that the abortion decision belongs to the patient or their obstetrician and not the anesthesia provider. CONCLUSIONS Southeastern US anesthesia providers are influenced by multiple factors when considering their participation in hospital-based abortion care. Acknowledging differences in professional and personal viewpoints and identifying roles in abortion decision-making might be important to engaging anesthesia providers in abortion care, especially for high-risk medical or fetal indications. IMPLICATIONS This original, qualitative study identified several inductive themes that characterize how Southeastern US anesthesia providers formulate their level of participation in hospital-based abortion care. Acknowledging differences in professional and personal viewpoints and identifying roles in abortion decision-making might facilitate interdisciplinary abortion care, especially for high-risk medical or fetal indications.
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Affiliation(s)
- Jennifer A Reeves
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Peggy Goedken
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Kelli S Hall
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Simon C Lee
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Carrie A Cwiak
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
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Cahn J, Sundaram A, Balachandar R, Berg A, Birnbaum A, Hastings S, Makansi M, Romano E, Majidi A, McCormick D, Gaffney A. The Association of Childbirth with Medical Debt in the USA, 2019-2020. J Gen Intern Med 2023; 38:2340-2346. [PMID: 37199904 PMCID: PMC10192781 DOI: 10.1007/s11606-023-08214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 04/13/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Medical debt affects one in five adults in the USA and may disproportionately burden postpartum women due to pregnancy-related medical costs. OBJECTIVE To evaluate the association between childbirth and medical debt, and the correlates of medical debt among postpartum women, in the USA. DESIGN Cross-sectional. PARTICIPANTS We analyzed female "sample adults" 18-49 years old in the 2019-2020 National Health Interview Survey, a nationally representative household survey. MAIN MEASURES Our primary exposure was whether the subject gave birth in the past year. We had two family-level debt outcomes: problems paying medical bills and inability to pay medical bills. We examined the association between live birth and medical debt outcomes, unadjusted and adjusted for potential confounders in multivariable logistic regressions. Among postpartum women, we also examined the association between medical debt with maternal asthma, hypertension, and gestational diabetes and several sociodemographic factors. KEY RESULTS Our sample included n = 12,163 women, n = 645 with a live birth in the past year. Postpartum women were younger, more likely to have Medicaid, and lived in larger families than those not postpartum. 19.8% of postpartum women faced difficulty with medical bills versus 15.1% who were not; in multivariable regression, postpartum women had 48% higher adjusted odds of medical debt problems (95% CI 1.13, 1.92). Results were similar when examining inability to pay medical bills, and similar differences were seen for privately insured women. Among postpartum women, those with lower incomes and with asthma or gestational diabetes, but not hypertension, had significantly higher adjusted odds of medical debt problems. CONCLUSIONS Postpartum women experience higher levels of medical debt than other women; poorer women and those with common chronic diseases may have an even higher burden. Policies to expand and improve health coverage for this population are needed to improve maternal health and the welfare of young families.
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Affiliation(s)
- Jordan Cahn
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Ayesha Sundaram
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Roopa Balachandar
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Alexandra Berg
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Aaron Birnbaum
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Stephanie Hastings
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Matthew Makansi
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Emily Romano
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Ariel Majidi
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Danny McCormick
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
| | - Adam Gaffney
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA USA
- Harvard Medical School, Boston, MA USA
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Gaffney A, Himmelstein DU, Dickman S, Myers C, Hemenway D, McCormick D, Woolhandler S. Projected Health Outcomes Associated With 3 US Supreme Court Decisions in 2022 on COVID-19 Workplace Protections, Handgun-Carry Restrictions, and Abortion Rights. JAMA Netw Open 2023; 6:e2315578. [PMID: 37289459 PMCID: PMC10251209 DOI: 10.1001/jamanetworkopen.2023.15578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 06/09/2023] Open
Abstract
Importance Several recent US Supreme Court rulings have drawn criticism from the medical community, but their health consequences have not been quantitatively evaluated. Objective To model health outcomes associated with 3 Supreme Court rulings in 2022 that invalidated workplace COVID-19 vaccine or mask-and-test requirements, voided state handgun-carry restrictions, and revoked the constitutional right to abortion. Design, Setting, and Participants This decision analytical modeling study estimated outcomes associated with 3 Supreme Court rulings in 2022: (1) National Federation of Independent Business v Department of Labor, Occupational Safety and Health Administration (OSHA), which invalidated COVID-19 workplace protections; (2) New York State Rifle and Pistol Association Inc v Bruen, Superintendent of New York State Police (Bruen), which voided state laws restricting handgun carry; and (3) Dobbs v Jackson Women's Health Organization (Dobbs), which revoked the constitutional right to abortion. Data analysis was performed from July 1, 2022, to April 7, 2023. Main Outcomes and Measures For the OSHA ruling, multiple data sources were used to calculate deaths attributable to COVID-19 among unvaccinated workers from January 4 to May 28, 2022, and the share of these deaths that would have been prevented by the voided protections. To model the Bruen decision, published estimates of the consequences of right-to-carry laws were applied to 2020 firearm-related deaths (and injuries) in 7 affected jurisdictions. For the Dobbs ruling, the model assessed unwanted pregnancy continuations, resulting from the change in distance to the closest abortion facility, and then excess deaths (and peripartum complications) from forcing these unwanted pregnancies to term. Results The decision model projected that the OSHA decision was associated with 1402 additional COVID-19 deaths (and 22 830 hospitalizations) in early 2022. In addition, the model projected that 152 additional firearm-related deaths (and 377 nonfatal injuries) annually will result from the Bruen decision. Finally, the model projected that 30 440 fewer abortions will occur annually due to current abortion bans stemming from Dobbs, with 76 612 fewer abortions if states at high risk for such bans also were to ban the procedure; these bans will be associated with an estimated 6 to 15 additional pregnancy-related deaths each year, respectively, and hundreds of additional cases of peripartum morbidity. Conclusions and Relevance These findings suggest that outcomes from 3 Supreme Court decisions in 2022 could lead to substantial harms to public health, including nearly 3000 excess deaths (and possibly many more) over a decade.
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Affiliation(s)
- Adam Gaffney
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
| | - David U. Himmelstein
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Hunter College, City University of New York, New York, New York
- Public Citizen Health Research Group, Washington, DC
| | | | | | - David Hemenway
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Danny McCormick
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Steffie Woolhandler
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Hunter College, City University of New York, New York, New York
- Public Citizen Health Research Group, Washington, DC
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11
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Moseson H, Smith MH, Chakraborty P, Gyuras HJ, Foster A, Bessett D, Wilkinson TA, Norris AH. Abortion-Related Laws and Concurrent Patterns in Abortion Incidence in Indiana, 2010-2019. Am J Public Health 2023; 113:429-437. [PMID: 36795983 PMCID: PMC10003501 DOI: 10.2105/ajph.2022.307196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 02/18/2023]
Abstract
Objectives. To analyze abortion incidence in Indiana concurrent with changes in abortion-related laws. Methods. Using publicly available data, we created a timeline of abortion-related laws in Indiana, calculated abortion rates by geography, and described changes in abortion occurrence coincident with changes in abortion-related laws between 2010 and 2019. Results. Between 2010 and 2019, Indiana's legislature passed 14 abortion-restricting laws, and 4 of 10 abortion-providing clinics closed. The Indiana abortion rate decreased from 7.8 abortions per 1000 women aged 15 to 44 years in 2010 to 5.9 in 2019. At all time points, the abortion rate was 58% to 71% of the Midwestern rate and 48% to 55% of the national rate. By 2019, nearly 1 in 3 (29%) Indiana residents who obtained abortion care did so outside the state. Conclusions. Access to abortion in Indiana over the past decade was low, required increases in interstate travel to obtain care, and co-occurred with the passage of numerous abortion restrictions. Public Health Implications. These findings preview unequal abortion access and increases in interstate travel as state-level restrictions and bans go into effect across the country. (Am J Public Health. 2023;113(4):429-437. https://doi.org/10.2105/AJPH.2022.307196).
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Affiliation(s)
- Heidi Moseson
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Mikaela H Smith
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Payal Chakraborty
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Hillary J Gyuras
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Abigail Foster
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Danielle Bessett
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Tracey A Wilkinson
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Alison H Norris
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
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12
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Worrell FC. Denying Abortions Endangers Women's Mental and Physical Health. Am J Public Health 2023; 113:382-383. [PMID: 36888952 PMCID: PMC10003498 DOI: 10.2105/ajph.2023.307241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Frank C Worrell
- Frank C. Worrell is the Distinguished Professor in the School of Education at the University of California, Berkeley. He served as the 2022 president of the American Psychological Association
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13
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Coverdale J, Gordon MR, Beresin EV, Guerrero APS, Louie AK, Balon R, Morreale MK, Aggarwal R, Brenner AM. Access to Abortion After Dobbs v. Jackson Women's Health Organization: Advocacy and a Call to Action for the Profession of Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:1-6. [PMID: 36369427 PMCID: PMC9652041 DOI: 10.1007/s40596-022-01729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Examination of the Public's Reaction on Twitter to the Over-Turning of Roe v Wade and Abortion Bans. Healthcare (Basel) 2022; 10:healthcare10122390. [PMID: 36553914 PMCID: PMC9777967 DOI: 10.3390/healthcare10122390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
The overturning of Roe v Wade reinvigorated the national debate on abortion. We used Twitter data to examine temporal, geographical and sentiment patterns in the public's reaction. Using the Twitter API for Academic Research, a random sample of publicly available tweets was collected from 1 May-15 July in 2021 and 2022. Tweets were filtered based on keywords relating to Roe v Wade and abortion (227,161 tweets in 2021 and 504,803 tweets in 2022). These tweets were tagged for sentiment, tracked by state, and indexed over time. Time plots reveal low levels of conversations on these topics until the leaked Supreme Court opinion in early May 2022. Unlike pro-choice tweets which declined, pro-life conversations continued with renewed interest throughout May and increased again following the official overturning of Roe v Wade. Conversations were less prevalent in some these states had abortion trigger laws (Wyoming, North Dakota, South Dakota, Texas, Louisiana, and Mississippi). Collapsing across topic categories, 2022 tweets were more negative and less neutral and positive compared to 2021 tweets. In network analysis, tweets mentioning woman/women, supreme court, and abortion spread faster and reached to more Twitter users than those mentioning Roe Wade and Scotus. Twitter data can provide real-time insights into the experiences and perceptions of people across the United States, which can be used to inform healthcare policies and decision-making.
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