There has yet to be published research on abortion knowledge and access in the deaf and hard of hearing (DHH) community. The study’s primary aim is to examine DHH experiences in family planning.

Since April 2021, this ongoing study has been collecting information about people with uteruses’ reproductive health experiences in the US. Our data from 193 participants shows 89% of participants identified as women, 21% as BIPOC, 56% as DHH. Using logistic and multivariate regression analysis, we examined how demographic and social factors affected a person’s knowledge of abortion methods as well as their use of emergency contraception.

Income and health insurance status were significant factors in a participant’s abortion knowledge (p-value = .004 and .011, respectively); the probability of knowledge increases as a participant has private insurance or as income increases. Looking specifically at medication abortion knowledge, education and health insurance were significant (p-value = .023 and <.05, respectively); the probability of knowledge increases as a participant has private insurance or with recipient of an undergraduate degree or higher than those with a high school diploma. No factors had a significant effect on use of emergency contraception. There was no difference observed between DHH and hearing respondents.

These preliminary results are already contributing to our understanding of DHH people’s family planning knowledge. While there was no significant difference between DHH and hearing respondents, responses revealed interesting trends related to knowledge of abortion methods and participants' income, insured status, and education levels.

Abortion attitudes in the U.S. are commonly assessed through a legality framework—whether abortion should be legal in general or in specific circumstances. With the Supreme Court’s decision in Dobbs v. Jackson, which overturned Roe v. Wade and eliminated the constitutional protection for abortion up to fetal viability, states have or will continue to make abortion illegal. In these states, people who do not want to remain pregnant will have to continue their pregnancy, seek abortion elsewhere, or seek other illegal means for obtaining an abortion. Research assessing public opinion on this first outcome—being forced to maintain pregnancy—is scant. Using survey data collected in 2021 in both English and Spanish (N = 2,489), we assessed the extent that people believe a woman should have to continue a pregnancy when she does not want to remain pregnant (i.e., forced pregnancy). We also assess attitudes toward “forced pregnancies” across 17 different circumstances (e.g., fetal defect, low income, mental health, failed contraception). We weighted data using the 2019 ACS and the GSS and conducted descriptive, correlational, and regression analyses to examine predictors of general support for “forced pregnancies” and predictors across circumstances. Assessing public opinion on “forced pregnancy” is most important post-Dobbs, as public opinion may influence state-level abortion legislations and eventually have implication for abortion access. If the public is not supportive of “forcing” people to continue unwanted pregnancies, this may require policy interventions to provide support for pregnant people in states where abortion is or will be restricted.

Background: Legal abortion in the US results in limited long-term adverse health outcomes for patients. Although some overestimate abortion-related health risks, most Americans and medical providers perceive it as safe. US adults overwhelmingly endorse legal abortion when there are medical risks for the pregnant person and fetus. That Americans trust in the safety of abortions and doctors in diagnosing health risk raises questions about how trust in medicine affects abortion attitudes. We examined medical trust and opinions about abortion legality, asking: How does trust of medical professionals affect beliefs about abortion safety and legality among US adults?

Methods: We used 110 qualitative interviews with English-speaking US adults to examine complexities in abortion attitudes. Interviews were analyzed using Applied Thematic Analysis.

Results: US adults endorse legal abortion for health exceptions--86% support abortion when the pregnant person’s life is endangered. Most respondents (61%) also stated that a physician should be involved in abortion decisions and procedures. Many participants (30%) conceptualized abortion legality as ensuring medical safety and discussed risk for abortions occurring outside formal medical establishments as reasons to maintain legal abortion (28%).

Discussion & Conclusion: For most Americans, legality means medical safety. Public opinion favors maintaining legal abortion specifically due to the safety that formal medicine provides. Our findings suggest explicit trust in formal medicine in the US and demonstrate a widespread belief that making abortion illegal will remove it from the purview of medicine, thus making it dangerous. This has implications for lawmakers as abortion regulations become more restrictive.

Objective: The purpose of this study is to examine national trends in ED utilization for induced abortion complications (IAC) and to explore the intersections with sociodemographic variables.

Methods: This study examined emergency department visits using data from the Nationwide Emergency Department Sample (NEDS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality from 2019-2020. These are the most recent years of NEDS data and are the only two years that included race. Visits with a diagnosis of IAC based on ICD10 codes in women aged 15-44 were included.

Results: 7312 visits had a diagnosis of IAC, with an admission rate of 15.8% compared to an admission rate of 7.3% (p<0.01) for total ED visits. Women aged 20-29 had a significantly higher proportion of ED visits for IAC than other age groups (p<0.01). Black patients were overrepresented relative to total ED visits (36.3% vs 25.8%, p<0.01) and were also overrepresented in the lowest income quartile (53.7% vs 36.2%, p<0.01) and the highest income quartile (24.2% vs 10.5%, p<0.01). White patients were underrepresented relative to total ED visits in all income quartiles (p<0.01).

Conclusion: The admission rates for IAC were significantly higher compared to total ED visits. Racial, economic and age-related disparities were identified with Black women having a higher percentage of visits and White women have a disproportionately lower percentage, relative to total ED visits. These data suggest that racial and socioeconomic disparities may be present and present an opportunity for intervention.

The devastating consequences of the Dobbs decision have become increasingly apparent: as of January 1, 2023, 19 states have attempted to enforce near-total bans with exceedingly narrow exceptions. Legal battles continue to play out across the country, adding to the confusion of a rapidly shifting landscape. Fear of prosecution chills the availability of abortion care, and unclear legal risk additionally impacts the provision of healthcare beyond abortion, such as management of miscarriage or other pregnancy complications. In an attempt to counter this hostile landscape, 17 states have enacted interstate “shield” laws, which aim to protect patients, providers, and helpers from out-of-state legal consequences related to abortion taking place in a state where the care is lawful. As both patients and providers struggle to understand their rights within a deeply inequitable and constantly evolving environment, timely research on abortion regulation is essential to safeguarding reproductive health and equity.

Using legal epidemiology methods, our team created an open-access longitudinal dataset of state laws that impact abortion access and service delivery post-Dobbs. Policy variables were coded to produce standardized legal data tracking policy developments in all 50 states and D.C. over a one-year period. The dataset captures restrictions related to abortion bans, self-managed abortion, medication abortion, and criminal penalties, and includes protective measures such as interstate shield laws, data privacy, ballot measures, and expanded access. This presentation will explore state-level trends in the dataset findings, describe the study’s empirical methods, and discuss implications of an uncertain legal landscape on access to reproductive healthcare.

Background: Terminating a pregnancy (TP) due to a fetal or maternal complication is multidimensional given personal, social, ethical, and legal considerations. Research has focused on psychological impacts of TP (e.g., distress, depression); little research has focused on social support (SS) needs from time of diagnosis through the postabortal period. This study examined SS needs among women who TP for fetal anomalies or threat to maternal health.

Methods: Guided by SS theory, semi-structured, in-depth interviews were conducted via Zoom with women (n=18) who TP for medical reasons in the U.S. Interviews were audio-recorded and transcribed. A codebook using a prior and emerging codes informed thematic analysis. Intercoder agreement was established, and the team agreed upon final themes.

Results: The majority self-identified as White, non-Hispanic, married and employed; most (n=16) TP due to fetal abnormalities. Women reported significant informational needs: diagnosis; termination options/procedures; post-abortal care; handling fetus remains; milk production; and family planning. Emotional needs included psychosocial impacts (e.g., fear, reassurance) and spanned from feelings pre-diagnosis, and dramatically shifted during diagnosis and pre/post-procedure periods. Women reported difficult appraisal processes, as self-evaluation included circumventing medical, personal, social, ethical, and legal factors, and health literacy considerations (e.g., medical jargon; risks/benefits). Instrumental support included transportation/traveling, funding, and childcare. Social support sources (e.g., partners, family, friends, healthcare providers/staff, social media) were perceived as welcomed, unwelcomed and lacking.

Conclusion: Women shared strenuous lived experiences and discussed supportive/unsupportive and available/unavailable SS. Future health system interventions based on SS may improve patient-centered care during this challenging time.

The Chicago Department of Public Health’s (CDPH) strategy to support reproductive health is four-fold: (1) public education and awareness, (2) policy advocacy, (3) external provider support, and (4) internal professional development.

When Roe v. Wade was overturned, Illinois had already codified abortion rights into law with the Reproductive Health Act signed by Governor Pritzker in 2019. In the intervening months, many states strengthened their anti-abortion laws, leaving Chicago among the few municipalities in the region providing this care. Abortion providers and advocates needed additional support to handle the influx of patients from other states, while providing care for Chicagoans.

CDPH serves the city of Chicago, but abortion providers within the city provide care for individuals from across the country. CDPH funds two delegate agencies to provide transportation, lodging, and medical costs for individuals seeking abortion care in Chicago, no matter where they live.

Major accomplishments include the founding of the Office of Reproductive Health, onboarding two delegate agencies via a competitive bid process, creation of the chicago.gov/abortioncare web page, and implementation support of two local ordinances that expand on reproductive health access. CDPH has demonstrated that local health departments have an important role in abortion care advocacy.

The Dobbs v. Jackson decision has had a chilling effect on advocacy, particularly in states hostile to abortion access. As this body of work has never been under the purview of the local health department, it was important to add to the capacity of and maintain the work of advocates.

Background: Millions of young women die every year due to unsafe abortion it represents an increase in health systems costs and a public health problem. Universal access to health services, including safe abortion, is essential to promote individual and collective health. Telemedicine represents an important strategy to ensure access to medical abortion procedures, reduce distance barriers and expand coverage to underserved communities.

Purpose: To examine literature regarding medical abortion provided via telemedicine compared with standard care.

Methods: Following Cochrane standard procedures, a literature search on electronic databases was conducted in January 2023. A combination of search terms regarding medical abortion, telemedicine and standard care were used to yield results. The search was not limited to the time of publication of the studies. Articles were screened and assessed by peer review.

Results: Twenty-one (21) articles met the inclusion criteria; five (5) studies with serious risk of bias, fifteen (15) with moderate risk and one (1) not established. Thirteen (13) studies compared medical abortion between telemedicine versus standard care. Telemedicine abortion effectiveness is similar with standard care (98.4% and 99.1% respectively). Few complications were reported and in similar proportions in both groups. No fatalities related to pharmacological treatments were reported. Telemedicine is preferred and has less waiting time for the start of treatment.

Conclusions: Most studies in this review had no comparison group, high loss to follow-up and self-reported measures. Medical abortion with telemedicine is an effective alternative, similar to standard care. The occurrence of complications is scarce in both modalities.

Background

Normalizing abortion and allowing people who have had abortions to speak freely may begin to break down some barriers and remind the public that abortion is common. This project used digital storytelling (DST) to document the abortion stories of Black women and measure the impact of participating in the DST process on individual stigma perception. Digital storytelling (DST) is a participatory research framework , resulting in short (1–5 minute), participant produced video documenting a personal experience.

Methods

Sixteen storytellers (8 in CA and 8 in IN) were recruited through organizational outreach, social media ads, and word of mouth. Storytellers were self-identified Black women aged 18 or older, living in CA or IN, who had at least one abortion, and were willing to participate in 5-session virtual DST workshop. All storytellers created a 3-5 minute digital story and completed a 1-hour post-workshop interview.

Results

We synthesized findings from narrative analysis of digital stories, field notes written in and around the DST workshop process, and follow-up individual interviews with workshop participants. Participants described the workshop as a safe, nurturing, and transformative space that was both healing and disruptive, allowing them to articulate, understand, and validate their abortion stigma experiences.

Conclusions

Digital storytelling is an empowering and disruptive method and serves as a critical narrative intervention, in which abortion storytellers’ engagement in the storytelling process enables them to collaboratively interrogate and potentially address trauma related to abortion stigma, bolster a sense of social support and solidarity, and potentially recalibrate stigmatizing conversations.