Leaps ahead in law but not in practice: Why we need to train in second trimester abortion care

Objectives. To examine changes in abortions in Louisiana before and after the COVID-19 pandemic onset and assess whether variations in abortion service availability during this time might explain observed changes. Methods. We collected monthly service data from abortion clinics in Louisiana and neighboring states among Louisiana residents (January 2018–May 2020) and assessed changes in abortions followin pandemic onset. We conducted mystery client calls to 30 abortion clinics in Louisiana and neighboring states (April–July 2020) and examined the percentage of open and scheduling clinics and median waits. Results. The number of abortions per month among Louisiana residents in Louisiana clinics decreased 31% (incidence rate ratio = 50.69; 95% confidence interval [CI] = 50.59, 0.79) from before to after pandemic onset, while the odds of having a second-trimester abortion increased (adjusted odds ratio [AOR] = 51.91; 95% CI = 51.10, 3.33). The decrease was not offset by an increase in out-of-state abortions. In Louisiana, only 1 or 2 (of 3) clinics were open (with a median wait >.2 weeks) through early May. Conclusions. The COVID-19 pandemic onset was associated with a significant decrease in the number of abortions and increase in the proportion of abortions provided in the second trimester among Louisiana residents. These changes followed service disruptions. (Am J Public Health. Published online ahead of print June 29, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306284 )

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Mixed-methods investigation of women’s experiences with second-trimester abortion care in the Midwest and Northeast United States

Contraception ◽

10.1016/j.contraception.2017.08.008 ◽

2017 ◽

Vol 96 (6) ◽

pp. 401-410 ◽

Cited By ~ 2

Author(s):

Kelly Blanchard ◽

Jill L. Meadows ◽

Hialy R. Gutierrez ◽

Curtiss PS Hannum ◽

Ella F. Douglas-Durham ◽

...

Keyword(s):

United States ◽

Mixed Methods ◽

Second Trimester ◽

Trimester Abortion ◽

Women’S Experiences ◽

Abortion Care ◽

Northeast United States ◽

Women's Experiences ◽

Second Trimester Abortion

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Induced Second Trimester Abortion and Associated Factors at Debre Markos Referral Hospital: Cross-Sectional Study

Women s Health ◽

10.1177/1745506520929546 ◽

2020 ◽

Vol 16 ◽

pp. 174550652092954

Author(s):

Bekele Tesfaye ◽

Mesenbet Tewabe ◽

Aster Ferede ◽

Angela Dawson

Keyword(s):

Cross Sectional Study ◽

Referral Hospital ◽

Second Trimester ◽

Sectional Study ◽

Trimester Abortion ◽

Cross Sectional ◽

Abortion Care ◽

Care Services ◽

Second Trimester Abortion ◽

Debre Markos

Background: Although most induced abortions in Ethiopia are performed in the first trimester, many women will still require second trimester abortions. While access to abortion in Ethiopia is limited, few data are being available concerning the demand for and associated outcomes of second trimester abortions. This knowledge is important for planning the health service response to abortion. Objective: The main objective of this study was to determine the proportion and associated factors of second trimester abortion among women presenting for abortion care services at Debre Markos Referral Hospital, Debre Markos, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted at Debre Markos Referral Hospital on a sample of 262 calculated using the single population proportion formula. Women who sought abortion services were interviewed consecutively from 12 February 2017 to 14 March 2017. Data were collected in a face-to-face exit interview and document review and analyzed using SPSS version 24.0 software. Bivariate and multivariable analyses were undertaken to identify factors. Result: Of the women who presented for abortion care services in Debre Markos Referral Hospital, 73 (29.6%) had induced second trimester abortion. Unmarried women (adjusted odds ratio = 4.93, 95% confidence interval = 1.41–17.16) and women employed at private business (adjusted odds ratio = 6.17, 95% confidence interval = 1.16–32.76) were associated with induced second trimester abortion. Conclusion: This study revealed that almost one-third of women who presented for abortion care services at Debre Markos Referral Hospital had induced second trimester abortions. Raising awareness of the health consequence of second trimester abortion at community levels and counseling to avoid further occurrences are helpful to minimize the problem. Furthermore, early management of induced second trimester abortion is very crucial to prevent further complications.

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