Abstract
Objectives
Study design
Results
Conclusions
Implications
Keywords
1. Introduction
Sobel L, Ramaswamy A, Frederiksen B, Salganicoff A. State action to limit abortion access during the COVID-19 pandemic. Kaiser Family Foundation; 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/state-action-to-limit-abortion-access-during-the-covid-19-pandemic/. [accessed June 1, 2022].
Guttmacher Institute. State Facts About Abortion: Texas. 2021. https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-texas. [accessed June 15, 2022].
Guttmacher Institute. State facts about abortion: Ohio. 2021. https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-ohio. [accessed June 15, 2022].
Acton A. Director's stay safe Ohio order. 2020. https://coronavirus.ohio.gov/static/publicorders/Directors-Stay-Safe-Ohio-Order.pdf. [accessed June 17, 2022].
Preterm-Cleveland v Attorney General of Ohio. Southern District of Ohio. 2020. https://www.courthousenews.com/wp-content/uploads/2020/04/4.23-abortion-injunction.pdf. [accessed June 01, 2022].
- Mello K
- Smith MH
- Hill BJ
- Chakraborty P
- Rivlin K
- Bessett D
- et al.
Abbott, G. Executive order GA 09: Relating to hospital capacity during the COVID-19 disaster. 2020. https://gov.texas.gov/uploads/files/press/EO-GA_09_COVID-19_hospital_capacity_IMAGE_03-22-2020.pdf. [accessed September 26, 2022].
Paxton, K. Health care professionals and facilities, including abortion providers, must immediately stop all medically unnecessary surgeries and procedures to preserve resources to fight COVID-19 pandemic. Press release. March 23, 2020. https://www.texasattorneygeneral.gov/news/releases/health-care-professionals-and-facilities-including-abortion-providersmust-immediately-stop-all. [accessed September 26, 2022].
Carpenter E, Burke KL, Vizcarra E, Dan'el A, White K. Texas’ executive order during COVID-19 increased barriers for patients seeking abortion care. 2021. https://liberalarts.utexas.edu/txpep/research-briefs/covid-abortion-patient-brief.php. [accessed May 31, 2022].
- Dozier JL
- Sufrin C
- Berger BO
- Burke AE
- Bell SO.
- Mello K
- Smith MH
- Hill BJ
- Chakraborty P
- Rivlin K
- Bessett D
- et al.
2. Materials and methods
2.1 Study design
2.2 Data collection
2.3 Data analysis
3. Results
3.1 Participant characteristics
Ohio (n = 12) | Texas (n = 10) | |
---|---|---|
Race/ethnicity | ||
Hispanic | 0 | 4 |
Black | 6 | 1 |
White | 4 | 4 |
Asian | 2 | 0 |
Declined to report | 0 | 1 |
Education | ||
Some high school | 1 | 0 |
High school | 2 | 3 |
Some College | 5 | 6 |
College degree | 2 | 1 |
Advanced degree | 2 | 0 |
Relationship status | ||
Single | 5 | 6 |
In a relationship, non-cohabiting | 4 | 3 |
Cohabitating | 2 | 1 |
Separated | 1 | 0 |
Parity | ||
0 | 8 | 1 |
1 | 1 | 3 |
2+ | 3 | 6 |
Abortion method | ||
Unable to obtain | 0 | 5 |
Medication abortion | 7 | 0 |
Procedural abortion | 5 | 5 |
3.2 Participants experienced delays and a more complex abortion-seeking process
I'm completely in the dark…A lot of [clinics] weren't answering or had weird hours because of COVID or just had too many customers calling them or something. When I finally got to reach someone, they told me that they were only doing abortions at one of the three clinics. (Ohio, Asian, age 23, uncertain about gestation, but estimated 7-8 weeks when initially sought care, appointment scheduled at time of interview).
When I called that first [clinic], they gave me an appointment for next Saturday. This was in late March. The day before the appointment, they [called] and [said], ‘Hey, we canceled all the appointments right now because the State of Texas, they're putting a hold on what we're doing’. (Texas, age 29, race/ethnicity not provided, estimated 5-6 weeks when initially sought care, uncertain about plans for pregnancy)
I went asking for an abortion, and they didn't tell me upfront that they didn't do that. They just said, ‘Don't worry, we're going to get you a sonogram. We're going to get you set up.’ Then when I got back into the room, where they did the sonogram, they told me how far along I was. I think I was 13 weeks, 12 weeks. After I asked them like three or four times, when can I schedule the abortion, they finally told me they don't do abortions. (Texas, age 31, white, 9-10 weeks when sought care, obtained an abortion at 14-15 weeks)
3.3 Physical and emotional consequences of delayed care
It just sucked, I just wanted to sleep [until] it was time for my abortion date, but I couldn't. I had to get up, do things, be a mom still… I was just trying to lay in bed those last few days until my appointment…I was vomiting, couldn't keep nothing down. I didn't know how I was even going to make it. (Ohio, age 29, Black, obtained an abortion at 9 weeks)
I guess I was trying to act like it [pregnancy] just wasn't true…It was a very hard choice. It took me a long time to ultimately make one…. It was March, and by the time I had made that decision, when I went to [clinics’] Facebook pages and they had a dark post about how they were closing down for a while, and that's when I thought that I didn't have any options. (Texas, white, age 35, obtained an abortion at 23 weeks out-of-state)
3.4 Delayed care affected participants’ preferred timing and method of abortion
When they finally did reopen, [the clinic] had called me. I went, and they told me I was too far along to be at that clinic. So, they had to send me to a different clinic for people who were further along in their pregnancy, which wasn't the way that I wanted to do it because I originally wanted to do the medical one, not the surgical one. (Texas, age 23, Hispanic, 8 weeks when initially sought care, obtained an abortion at 17 weeks)
“At that point, [I] just wanted the surgical, but it did take a delay because of the um anesthesiologist was only in... the next time that she was available to take me was going to be like a week or so after. I didn't want to wait so I just ended up just deciding to do the medical abortion. [...] but I had really wanted to the surgical because you know it's gone. (Ohio, age 26, Black, 4 weeks when initially sought care, obtained an abortion at 6 weeks).
I would've [preferred a medication abortion] just because I wouldn't have had to spend so much time in the clinic…that's where the resentment comes from, feeling like I didn't [have] full agency. Abortion is a very time-sensitive procedure… [the executive order] honestly felt irresponsible to me, so I do resent that…. It was not gender inclusive. So, I was misgendered…But for me being trans, it's not exactly the full care that I need. (Ohio, age 24, Black, 6 weeks when initially sought abortion care, obtained an abortion at 9 weeks)
I'm 14 weeks, and I decided to go ahead and go through with the pregnancy. I was going to get an abortion when I was four weeks, but then when they closed everything down, meaning I was 12 weeks when I could make an appointment…that's already too far along [for my comfort], and I wouldn't feel comfortable anymore. (Texas, age 28, race/ethnicity not provided, 4 weeks when initially sought care, decided not to get an abortion at 12 weeks)
I don't think I am brave enough to go through with a surgical procedure. It sounds really scary to me [….] I probably would not do it. I was so very frightened to go through with the surgical procedure. (Ohio, age 23, white, 4 weeks when initially sought abortion care, appointment scheduled at time of interview)
4. Discussion
- Dozier JL
- Sufrin C
- Berger BO
- Burke AE
- Bell SO.
- Mello K
- Smith MH
- Hill BJ
- Chakraborty P
- Rivlin K
- Bessett D
- et al.
Carpenter E, Burke KL, Vizcarra E, Dan'el A, White K. Texas’ executive order during COVID-19 increased barriers for patients seeking abortion care. 2021. https://liberalarts.utexas.edu/txpep/research-briefs/covid-abortion-patient-brief.php. [accessed May 31, 2022].
White K, Sierra G, Dixon L, Sepper E, Moayedi G. Texas Senate Bill 8: Medical and legal implications. 2021. https://sites.utexas.edu/txpep/files/2021/07/TxPEP-research-brief-senate-bill-8.pdf. [Accessed June 18 2022].
Nash E, Cross L. 26 States are certain or likely to ban abortion without Roe: Here's which ones and why. 2022. https://www.guttmacher.org/article/2021/10/26-states-are-certain-or-likely-ban-abortion-without-roe-heres-which-ones-and-why. [Accessed July 1, 2022].
4.1 Limitations
Acknowledgments
References
Sobel L, Ramaswamy A, Frederiksen B, Salganicoff A. State action to limit abortion access during the COVID-19 pandemic. Kaiser Family Foundation; 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/state-action-to-limit-abortion-access-during-the-covid-19-pandemic/. [accessed June 1, 2022].
Guttmacher Institute. State Facts About Abortion: Texas. 2021. https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-texas. [accessed June 15, 2022].
Guttmacher Institute. State facts about abortion: Ohio. 2021. https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-ohio. [accessed June 15, 2022].
Acton A. Director's stay safe Ohio order. 2020. https://coronavirus.ohio.gov/static/publicorders/Directors-Stay-Safe-Ohio-Order.pdf. [accessed June 17, 2022].
Preterm-Cleveland v Attorney General of Ohio. Southern District of Ohio. 2020. https://www.courthousenews.com/wp-content/uploads/2020/04/4.23-abortion-injunction.pdf. [accessed June 01, 2022].
- Federal, state, and institutional barriers to the expansion of medication and telemedicine abortion services in Ohio, Kentucky, and West Virginia during the COVID-19 pandemic.Contraception. 2021; (S0010782421001360)https://doi.org/10.1016/j.contraception.2021.04.020
Abbott, G. Executive order GA 09: Relating to hospital capacity during the COVID-19 disaster. 2020. https://gov.texas.gov/uploads/files/press/EO-GA_09_COVID-19_hospital_capacity_IMAGE_03-22-2020.pdf. [accessed September 26, 2022].
Paxton, K. Health care professionals and facilities, including abortion providers, must immediately stop all medically unnecessary surgeries and procedures to preserve resources to fight COVID-19 pandemic. Press release. March 23, 2020. https://www.texasattorneygeneral.gov/news/releases/health-care-professionals-and-facilities-including-abortion-providersmust-immediately-stop-all. [accessed September 26, 2022].
Carpenter E, Burke KL, Vizcarra E, Dan'el A, White K. Texas’ executive order during COVID-19 increased barriers for patients seeking abortion care. 2021. https://liberalarts.utexas.edu/txpep/research-briefs/covid-abortion-patient-brief.php. [accessed May 31, 2022].
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White K, Sierra G, Dixon L, Sepper E, Moayedi G. Texas Senate Bill 8: Medical and legal implications. 2021. https://sites.utexas.edu/txpep/files/2021/07/TxPEP-research-brief-senate-bill-8.pdf. [Accessed June 18 2022].
- How Ohio's proposed abortion bans would impact travel distance to access abortion care.Perspect Sex Repro H. 2022; 54: 54-63https://doi.org/10.1363/psrh.12191
Nash E, Cross L. 26 States are certain or likely to ban abortion without Roe: Here's which ones and why. 2022. https://www.guttmacher.org/article/2021/10/26-states-are-certain-or-likely-ban-abortion-without-roe-heres-which-ones-and-why. [Accessed July 1, 2022].
Article info
Publication history
Footnotes
☆Disclosures: Research activities in Texas were supported by the Susan Thompson Buffett Foundation and a center grant awarded to the Population Research Center at the University of Texas by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD042849). Kristen Burke was also supported by the National Science Foundation Graduate Research Fellowship Program (DGE-1610403).
☆☆Funding: Research in Ohio was supported by an anonymous foundation. The funders played no role in the design or conduct of this study or in the preparation and review of this manuscript. The content is the responsibility of the authors and does not necessarily reflect the views of the funders.