ANSIRH research
ANSIRH research: Abortion
Nearly half of pregnancies in the United States are considered “unintended,” and at least half of these pregnancies are carried to term. Although accidental pregnancies are common, evidence about how women make decisions about their pregnancies and the health care they want and are able to obtain is surprisingly limited.
Read more...In 2017, abortion in Chile was decriminalized. Now women can legally access abortion in cases of rape, lethal fetal anomaly, and to preserve a woman’s life.
This study is assessing whether future women’s health professionals in Chile welcome or are prepared for this legal change. A better understanding of their attitudes about and willingness to provide abortion is critical to identifying reproductive health training needs and the barriers that would need to be overcome if abortion were liberalized in Chile.
Read more...The Desire to Avoid Pregnancy (DAP) scale is a psychometrically validated measure of a woman’s preferences about a future pregnancy and childbearing.
Read more...ANSIRH’s Evaluation of Restrictions Project aims to examine the effects on women of state-level abortion restrictions and to identify strategies to mitigate the negative impacts. The project started in 2013 and has so far conducted research in ten states and evaluated the effects of a variety of restrictions. We continue to identify states and restrictions to evaluate.
Read more...On January 1, 2014, California enacted legislation (AB 154) culminating a decade worth of work to expand the pool of safe, qualified professionals authorized to provide early abortion care.
Read more...The MAP Study aims to better understand demand and interest in three hypothetical new provision models for medication abortion access: 1) obtaining abortion pills on prescription in advance from a provider in case of an unintended pregnancy; 2) ordering abortion pills online; and 3) purchasing medication abortion pills in a drug store or grocery without prescription.
Read more...Medication abortion is a simple, safe, and effective abortion method that makes up about one in four abortion procedures taking place in the United States. The nature of medication abortion gives it the potential to be accessible outside of the traditional healthcare setting – meaning women would have more control and autonomy over their abortion experience. However, abortion access is restricted in the US, including how medication abortion pills can be dispensed.
Read more...Despite their enormous and trusted role in health care, nurses are often unprepared to care for the woman with an unintended pregnancy who want to seek abortion. This leads to staffing shortages that prevent women’s access to abortion care, and a lost opportunity for nurses to serve as a trusted health resource for women seeking abortion.
Read more...Current regulations restrict access to medication abortion and contribute to the perception that people cannot safely take medication abortion pills (mifepristone and misoprostol) on their own without clinician supervision. Yet, mifepristone and misoprostol meet many of the FDA’s criteria for being available over the counter. They are safe, have no risk of overdose, are not addictive, and people are already using them safely on their own in many parts of the world. The possibility of an over-the-counter medication abortion model would involve the medications being available without a prescription in a drug store or grocery, similar to emergency contraception or condoms and pregnancy tests. The pills would come with detailed instructions as well as information about access to a number of different resources, such as a 24-hour telephone number to call with questions about the medication.
Read more...Over 70% of religious hospitals are Catholic. Catholic facilities adhere to the Ethical and Religious Directives for Catholic Healthcare Services which prohibit abortion, contraception (including tubal-ligation), infertility treatment and more. Catholic hospitals treat 1 out of 6 acute care patients in the United States.
Read more...Pharmacists play an important role in the provision of reproductive health care, including prescribing hormonal contraception and emergency contraception in some states. But pharmacists have limited involvement in abortion care, primarily due to the FDA’s dispensing restrictions on mifepristone. There is increasing interest in removing the dispensing restrictions on mifepristone in the United States, which would enable pharmacists to dispense the drug directly to patients with a prescription from their clinician. We are conducting a study, under an Investigational New Drug (IND) application to the FDA, examining the effectiveness and acceptability of pharmacist dispensing of medication abortion.
Read more...ANSIRH’s Primary Care Initiative (PCI) aims to expand access to early abortion care by integrating sexual and reproductive health care within primary health care. To advance this goal, PCI projects focus on translating evidence into health care practice and policy.
Read more...Nearly half of the countries with liberal or liberally interpreted abortion laws had public funding for abortion, including most countries that liberalized their abortion law in the past 20 years. Outliers remain, however, including among developed countries where access to abortion may be limited due to affordability.
Read more...The Public Health Approaches to Abortion project is a series of projects that aim to ground the public and policy debate about abortion regulation and access in scientific evidence and public health principles. Collectively, these projects serve to re-center scientific evidence and public health professional expertise in discussions of abortion patient safety and health department engagement with abortion.
Read more...ANSIRH’s work in Reproductive Autonomy investigates women’s power to control matters regarding contraceptive use, pregnancy, abortion, and childbearing. Our research is done in the U.S. and internationally and involves measurement development, social science research, and literature reviews.
Read more...Because of the provisions of the Hyde Amendment, a federal law that prohibits federal funding from being used for abortion care except in the case of rape, incest or life endangerment, the hundreds of thousands of women serving in the U.S. military face unique barriers to accessing care.
Read more...Since 2010, restrictions passed by state legislatures may have affected millions of women and caused at least 70 abortion providing facilities to close. ANSIRH’s Evaluation of Abortion Restrictions project is examining how abortion laws affect women’s access to and experience with abortion.
Read more...Abortion in the United States has become increasingly difficult to access, particularly with the closure of abortion clinics and an already insufficient number of abortion providers. A recent study by ANSIRH researchers found that there are 27 “abortion deserts” in the US, or cities where the lack of abortion facilities may force people to travel over 100 miles to get abortion care. Provision of medication abortion by telemedicine has the potential to fill some of those deserts, especially when combined with delivery of mifepristone and misoprostol by mail-order. Research in several states is evaluating the impact of telemedicine on abortion care.
Read more...The “November Gang” is an important, but little known, grouping within the world of abortion provision. This group, which met for the first time in November 1989, and continues to meet to this day, was initially summoned by Charlotte Taft, then the director of a clinic in Texas, and Sandra Bagley, the director of a clinic in Utah.
Read more...The Turnaway Study is a prospective longitudinal study examining the mental health, physical health, and socioeconomic consequences of receiving an abortion compared to carrying an unwanted pregnancy to term. From 2008 to 2010, we recruited from 30 abortion facilities around the country to recruit about 1,000 women who sought abortions, some who received abortions because they presented for care under the gestational limit of the clinic and some who were “turned away” and carried to term because they were past the gestational limit.
Read more...Ultrasound in the context of abortion care has received more attention in recent years as states have passed regulations mandating specific ultrasound procedures. Already 23 states have enacted such laws, requiring abortion providers to perform ultrasounds and/or offer fetal images and heart tone sounds to patients.
Read more...Medi-Cal is California’s state Medicaid program, and one of 17 state Medicaid programs that covers abortion and subsequent care. Medi-Cal covers 49% of abortions in California and 8% of abortions in the country. Medi-Cal data present a unique opportunity to understand abortion care because it can be used to track all subsequent care among a cohort of patients having an abortion longitudinally after their abortion with virtually no loss to follow-up. We utilized Medi-Cal data to better understand abortion safety, distance traveled for abortion, and sources of care after abortion.
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