142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Managing barriers to abortion access in the context of new laws: Perspectives from providers in North Carolina

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:10 PM - 1:30 PM

Mara Buchbinder, PhD , Social Medicine, UNC Chapel Hill, Chapel Hill, NC
Rebecca Mercier, MD , Obstetrics and Gynecology, Thomas Jefferson University School of Medicine, Philadlephia, PA
Amy Bryant, MD , Department of Obstetrics and Gynecology, UNC Chapel Hill
Background: Laws governing the provision of abortion are proliferating throughout the United States and increasingly regulate specific aspects of clinical care. Little is known about how these laws affect abortion providers and their clinical practice.

Methods: We conducted a qualitative study to investigate the experiences of abortion providers in North Carolina practicing under the 2011 Women’s Right to Know Act (WRTK), which mandates that women receive counseling with specific, state-prescribed information at least 24 hours prior to an abortion procedure. Thirty-one abortion providers and clinic managers from 11 of 16 NC abortion clinics participated in a semi-structured, in-person interview. Interviews were digitally recorded and transcripts coded using Dedoose software and an inductive, iterative analytic approach.

Results: Most providers indicated that WRTK had not imposed a substantial burden on women. However, providers devoted significant labor and resources to minimizing the impact of WRTK on patients, including hiring additional staff and reassigning job duties, reorganizing clinic procedures, seeking legal counsel, and performing state-mandated counseling during non-business hours. The impact of WRTK on providers varied depending on practice context. Providers in freestanding clinics that offered only abortion care experienced more difficulties complying with the law.

Discussion: Providers play a key role in adapting to legislative changes and preserving abortion access. These findings suggest that research focused on abortion rates and patient impact does not account for the significant “behind-the-scenes” work providers undertake to mitigate the harmful effects of new abortion laws.

Learning Areas:

Advocacy for health and health education
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Social and behavioral sciences

Learning Objectives:
Describe how abortion providers adapt to new laws to preserve access to safe abortion care; Identify sources of variation in abortion providersí experiences of legislative change.

Keyword(s): Abortion, Law

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a social scientist with expertise in qualitative research focused on the impact of public health policies on clinical practices and the patient-provider relationship.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.