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Objectives
To describe experiences with abortion counseling and access to care among patients
with lethal or life-limiting fetal diagnoses in Texas following enactment of Senate
Bill 8 (SB8).
Methods
In this qualitative study, we recruited patients who had an abortion after the enactment
of SB8 and used semi-structured interviews to explore how SB8 impacted abortion care.
Two researchers coded all transcripts using an inductive technique and analyzed themes
in an iterative approach.
Results
We interviewed 14 participants who reported gestational ages at the time of abortion
from 13 to 29 weeks. Participants described a loss of the therapeutic physician-patient
relationship and feelings of isolation while pursuing abortion due to the limitations
imposed by SB8. For example, participants felt there was a physician “gag rule” regarding
abortion (“the unspoken word of termination”), resulting in a greater need to initiate
their own research and invest personal resources (eg, finances, knowledge) into understanding
their pregnancy options and obtaining an abortion. Participants also expressed fears
regarding confidentiality with clinicians and their support system (“I would joke
around and say, ‘Well, don't sue me,’ but halfway mean it.”) and need to assess personal
safety when self-referring for abortion (“‘You're on your own…go find somebody that
can do this…’”).
Conclusions
Bounty hunter abortion restrictions like SB8 erode the physician-patient relationship.
These restrictions evoke fear and safety concerns during a vulnerable time for those
undergoing abortion for fetal diagnoses. Patients shoulder a significant burden of
understanding pregnancy options and navigating the process of abortion alone, which
could result in further disparities.
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© 2022 Published by Elsevier Inc.
