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Comparing preference for and use of medication abortion in Texas after policy changes in 2014 and 2018

  • Sarah E Baum
    Correspondence
    Corresponding author.
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Ibis Reproductive Health, Oakland, CA, United States
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  • Gracia Sierra
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Population Research Center, The University of Texas at Austin, Austin, TX, United States
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  • Daniel Grossman
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, Oakland, CA, United States
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  • Elsa Vizcarra
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Population Research Center, The University of Texas at Austin, Austin, TX, United States
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  • Joseph E Potter
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Population Research Center, The University of Texas at Austin, Austin, TX, United States
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  • Kari White
    Affiliations
    Texas Policy Evaluation Project, Population Resource Center, The University of Texas at Austin, Austin, TX, United States

    Population Research Center, The University of Texas at Austin, Austin, TX, United States

    Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
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      Abstract

      Objectives

      Assess preferences for and use of medication abortion in Texas after implementation of two policy changes: a 2013 state law restricting medication abortion and the FDA label change for mifepristone in 2016 nullifying some of this restriction.

      Study design

      We analyzed surveys conducted in 2014 and 2018 with abortion patients at 10 Texas abortion facilities. We calculated the percentage of all respondents with an initial preference for medication abortion by survey year, and the type of abortion obtained or planned to obtain among those who were at <10 weeks of gestation. We used multivariable-adjusted mixed-effects Poisson regression models to assess factors associated with medication abortion preference and actual/planned use.

      Results

      Overall, 156 (41%) of 376 respondents in 2014 and 247 (55%) of 448 respondents in 2018 reported initial preference for medication abortion (Prevalence ratio [PR]: 1.28; 95% CI 1.03−1.59). Among those who were <10 weeks of gestation and initially preferred medication abortion, 39 of 124 (31%) obtained or were planning to obtain the method in 2014, compared with 188 of 223 (84%) in 2018 (PR: 2.65; 95% CI: 1.69−4.15). After multivariable adjustment, respondents who initially preferred medication abortion and were 7 to 9 weeks of gestation at the time of their ultrasonography (vs <7 weeks) were less likely to obtain or plan to obtain the method (PR: 0.69; 95% CI: 0.57−0.84).

      Conclusions

      Abortion patients were more likely to prefer and obtain or plan to obtain their preferred medication abortion after legal restrictions in Texas were nullified.

      Implications

      State policies can affect people's ability to obtain their preferred abortion method. Efforts to provide both abortion options whenever possible, and inform people where each can be obtained, remains an important component of person-centered care despite increasing state abortion restrictions and bans following the reversal of Roe v Wade.

      Keywords

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