AI Article Synopsis

  • The study investigates the impact of the 2022 Dobbs decision on access to second- and third-trimester abortions using fetal potassium chloride (KCl) injections in Colorado, a state with protective laws.
  • An increase in the number of patients seeking KCl injections was observed, with a 6.4-fold rise post-Dobbs, highlighting a significant increase in the distance traveled for procedures (from 29.8 to 383.9 miles on average).
  • While the area deprivation index remained unchanged, the data suggests a growing need for these abortion procedures, indicating ongoing access challenges even in states with protective legislation.

Article Abstract

Changes in the U.S. laws, particularly the Dobbs decision in 2022, altered access to abortions. Fetal potassium chloride (KCl) injections can be used for second- and third-trimester abortions. This descriptive study aims to present the characteristics of patients who received KCl injections in a state with protective laws (Colorado), including pre- and post-Dobbs. Patients undergoing KCl injection at our institution between January 2014 and December 2023 were included. Records were reviewed for demographic data, parity, and procedure details. Distance traveled and area deprivation index (ADI) were determined based on residence data. Group differences pre- and post-Dobbs were analyzed using Chi-squared and Mann-Whitney tests. Subanalyses were performed to compare in-state and out-of-state (OOS) patients. One hundred and nineteen patients were included: 56 pre-Dobbs and 63 post-Dobbs, representing a 6.4-fold increase in volume post-Dobbs. Patients were from 10 states of residence pre-Dobbs and 17 post-Dobbs. Median distance traveled significantly increased post-Dobbs, 29.8 versus 383.9 miles ( = 0.004). The maximum distance traveled was 855 miles pre-Dobbs and 1,201 miles post-Dobbs. ADI did not vary pre- or post-Dobbs. Singleton procedures increased post-Dobbs for all patients. There was no change in gestational duration at the time of procedure across any comparison. Procedure volume and distance traveled increased for both in-state and OOS patients with minimal change in patient characteristics pre- and post-Dobbs. Our data indicate an increased need for these procedures, even in a state with protective laws.

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http://dx.doi.org/10.1089/jwh.2024.0521DOI Listing

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