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Exploring barriers and facilitators to medical abortion practice: a qualitative study with Canadian healthcare providers who choose not to provide mifepristone

Sarah Munro, University of British Columbia

Project abstract

Recent years have seen a surge in legislation to restrict state-level abortion access, often rationalized by lawmakers as protective to maternal and child health. Lack of abortion access may potentially have downstream infant health consequences, particularly for women who have to continue unwanted pregnancies to term and may experience increased psychological distress as well as increased likelihood of engaging in high-risk prenatal health behavior (e.g., substance use and lack of prenatal care utilization). Further, vulnerable populations that disproportionately experience unintended pregnancies are likely to be most affected by these policies. However, empirical studies have not yet evaluated the associations between longitudinal state variation in recently enacted abortion access restrictions with infant health outcomes (birthweight, gestational age, and infant death).

To investigate this, state-level abortion law data on hospital privileges and proximity requirements, “partial-birth” abortion bans, mandatory ultrasounds, and private insurance prohibition will be synthesized with Period Linked Live Birth-Infant Death Data Files from 1999-2014. By comparing states with and without changes in abortion restrictions, both before and after these policy changes were implemented, we can examine the infant health effects of having any restrictions, of the severity of restrictions, and of the specific types of abortion restrictions. We will replicate these analyses in vulnerable populations (e.g., less educated women) in order determine whether changes in law are particularly impactful for sub-populations. These findings may inform future family planning research and practice, as well as policy discussion regarding enactment or repeal of abortion restrictions.


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