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News from ANSIRH

ANSIRH News

Telemedicine reduces barriers to accessing medication abortion

In our commentary on the Gynuity Telabortion study, we note that telemedicine abortion can help mitigate existing barriers to abortion, such as having to travel long distances for care, losing wages from taking time off work and paying for gas, public transit fare or hotel and childcare.

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Women entering prenatal care report unmet need for social services

Policy restrictions on abortion result in some women being unable to obtain an abortion and instead, continuing their pregnancies. These women may have unique needs when entering prenatal care. We conducted both surveys and interviews with women entering prenatal care in Louisiana and Maryland, and found that the most commonly reported social service needs included WIC, food stamps, dental care, and housing assistance. Women who faced a policy-related barrier to obtaining an abortion reported the highest unmet social service needs. Policy makers should focus on both improving access to abortion and to social services support.

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Majority of TV abortion plotlines reinforce myths about the procedure

We viewed all plotlines on American scripted television between 2008 and 2018 that contained an abortion, and found that only 40% of plotlines depict some aspect of the abortion procedure, the majority of which are surgical abortions. Less than a quarter of plotlines depict medication abortions, contrasting with real life in which one third of patients have an abortion by pill. Plotlines involving a surgical abortion often (but not always) occur in hospitals, and medication abortions are often both easy to access and are associated with danger or death. This misinformation may lead to unnecessary fear and anxiety amongst abortion patients, and cause confusion about the safety and accessibility of abortion.

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Impact of policies targeting alcohol use during pregnancy varies by race

Over the last 40 years, most states have implemented at least one law targeting alcohol use during pregnancy, yet little research has examined impacts of these laws. This study examines whether effects of these policies on birth outcomes and prenatal care use vary by race. Impacts of alcohol/pregnancy policies do vary by race for preterm birth, vary in a few cases for low birth weight, and generally do not vary for prenatal care utilization. Most policies had adverse impacts on preterm birth and/or low birth weight birth for White women. Some policies had beneficial impacts for preterm birth for Black women, and one had an adverse impact for low birth weight. More research is needed to understand why policies have opposite effects for White and Black women.

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Medicaid abortion restrictions are an insurmountable barrier

The Hyde Amendment imposes restrictions on Medicaid’s ability to provide insurance coverage for abortion. This study is the most recent research to estimate the impact of this lack of coverage. Researchers conducted both surveys and structured interviews with women entering prenatal care in Southern Louisiana. The study confirmed the continued accuracy of a decade-old statistic, finding that about one forth of Medicaid-eligible pregnant women who would have had an abortion instead give birth instead of have an abortion because of lack of Medicaid coverage for abortion. The Hyde Amendment continues to substantially limit women’s ability to obtain wanted abortions.

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Study finds no evidence that having an abortion leads to negative health outcomes

Previous studies show that, in the short term, childbirth is associated with more health risks than abortion. But less is known about the long term health of women who have abortions compared to those who give birth. In the Turnaway Study, we compared the long term physical health of women who received a wanted abortion to those who were denied a wanted abortion and gave birth. Our data provide evidence that having an abortion is not detrimental to a person’s health, but being denied a wanted abortion is. 

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Using Telemedicine for Mandatory Pre-Abortion Information Sessions Reduces Barriers to Abortion Care

In states with laws requiring patients to attend an initial information visit before they obtain an abortion, allowing patients to participate in information sessions via telemedicine can reduce financial and logistical burdens. In our study, we interviewed 18 women in Utah who used telemedicine to attend information visits before receiving an abortion.

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Policies targeting alcohol use in pregnancy harm instead of help

Most states have policies targeting alcohol and drug use during pregnancy. Previous research finds that, at best, these policies do not affect use during pregnancy, prenatal care use, or birth outcomes. At worst, some policies lead to increases in low birthweight and preterm birth and to decreases in prenatal care. This study adds estimates the number of babies born low birthweight or preterm due to these policies and their associated costs. Policymakers should consider the adverse public health impacts of these laws before expanding them to new states or new substances.

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Policies to decrease alcohol use during pregnancy may not work as intended

Many states have laws with the stated goal of decreasing alcohol use during pregnancy, yet it is not known how effective these laws are. This study examined the relationship between these policies and alcohol use among pregnant women. We found that most alcohol and pregnancy policies are not associated with alcohol use during pregnancy. These findings do not demonstrate that there is a specific set of policies targeting alcohol use during pregnancy that policy makers should implement. New policy approaches may be needed to address alcohol use during pregnancy.

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There is no evidence to support abortion pill “reversal”

Between 2015 and 2019, legislators in at least 14 states have introduced bills that would require clinicians to inform patients during pre-abortion counseling that the abortion pill can be “reversed” if a woman were to change her mind after taking it. This is despite the fact that medication abortion is safe and that the vast majority of women who choose abortion do not regret their decision. So-called abortion “reversal” bills have been passed into law and implemented in four states as of 2019: Arkansas, Idaho, South Dakota, and Utah. 

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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