Background: More people are self-managing abortions (SMA) outside the formal medical system, yet with greater legal risks (particularly for people of color). The primary pathway of legal risk is from health care providers reporting to government authorities.

Methods: We collected survey data from health professionals registering for a webinar about pregnancy, substance use, and child welfare reporting. The survey included two SMA reporting statements with Likert responses: “A clinician who sees a patient who attempted to end a pregnancy on their own has an ethical obligation to keep this information confidential”, and “I think clinicians should be required by law to report patients who attempt to end a pregnancy on their own to legal authorities.”

Results: 583 of 592 survey participants completed the SMA reporting questions. Nurses (24%), social workers (23%), physicians (14%), public health (16%), and others (23%) participated. More were from the West (33%) and Northeast (35%) than Midwest (17%) and South (15%). 74% agreed clinicians have an obligation to keep information confidential; 11% disagreed and 15% were neutral. 81% disagreed that clinicians should have an obligation to report; 6% agreed and 13% were neutral. Beliefs varied by profession. Fewer social workers (65%) and nurses (73%) agreed clinicians have an obligation to keep information confidential and fewer social workers (77%) and nurses (82%) disagreed clinicians should have an obligation to report, compared to physicians (87% and 96%, respectively). Beliefs did not vary by region.

Discussion: Most health professionals do not support reporting requirements, although views varied by profession.

Louisiana is one of 14 states that banned abortions after the United States Supreme Court overturned the constitutional right to abortion services in June 2022. Attempts to pass bills that allow exceptions have been unsuccessful to date. We aim to explore what rhetorical tools are used by those in support and in opposition of an exception for pregnancies caused by a sexual offense, heard in the Louisiana Administration of Criminal Justice Committee in 2023.

We conducted a qualitative discourse analysis of testimony in the Committee hearing for HB 346. We accessed a publicly available recording of the Committee hearing, transcribed it, and used an inductive approach to iteratively generate a codebook that we independently applied to the data. We then conducted a thematic analysis to identify salient themes.

Abortion is represented as being traumatic, adding to the trauma caused by sexual violence, while representing childbearing as healing from trauma. Being conceived as a result of sexual violence is used as an identity marker worthy of protection. Religious rhetoric permeates testimony both in support and in opposition to abortion exceptions, making a “pro-life” stance the starting point for debate. Lastly, we find evidence of dehumanization of survivors’ and others’ experience.

Language constructs public discourse and advocates must develop tools to reframe narratives in support of reproductive justice. Findings from this study can be used to prepare legislators to better use questions to reframe and redirect discourse, as well as train grassroots organizations to better prepare community members who wish to testify.

Background: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision exacerbated inequitable access to abortion in the US. Agreement is needed on which strategies should be prioritized to restore, protect, and expand abortion access.

Methods: We convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement >67%) on recommended actions. Using feedback from three rounds of surveys, and input from a select expert advisory group (N=10), we iteratively refined the consensus points.

Results: The panel (N=85) developed 25 consensus statements and 32 recommendations for action in states with protected, mixed, or restricted access to abortion based on categorizations by the Guttmacher Institute. In states with protected access, key recommendations (i.e., >70% agreement) were to incorporate abortion into primary care and expand clinical services to include all types of abortion. In states with mixed access, key recommendations were to establish pathways for patients seeking abortion, lobby for Medicaid coverage of abortion, expand clinical services to include all types of abortion, and build broad coalitions for abortion access. In states with restricted access to abortion, the key recommendations were to combat gerrymandering and voter suppression, train emergency room staff in abortion care, establish protections against criminalization, and flip state legislatures.

Conclusions: This Delphi study identified actionable priorities in addressing inequitable access to abortion in states with varied policy environments. It also highlights areas where more strategic discussions are needed (e.g., the utility of boycotts in states with abortion bans).

Post-Dobbs v. Jackson, many states have restricted or banned abortion (or are likely to do so) with very limited exceptions based on gestational age or fetal development markers. We analyzed US adults’ attitudes toward government-enforced abortion restrictions based on six gestational and fetal time points (e.g., when sperm and egg join, when fetal heartbeat can be detected, viability) and a seventh option—the government should never be able to prohibit abortion. We used open-ended data from an online survey we administered in 2020 using Growth from Knowledge (GfK) to English- (n=1094) and Spanish-speaking (n=489) respondents. We aimed to answer: (1) what is the earliest point in a pregnancy that people think the government should prohibit abortion?; (2) why do people think this should be the earliest point?; (3) are there differences across survey language? Preliminary findings indicate that people most commonly indicated the government should be able to prohibit abortion: never (24%), “when a fetal heartbeat can be detected” (23%), or “when a sperm and egg join” (17%). A greater proportion of English-speakers indicated that gestational development markers should be used to determine abortion legality (36.1% v. 30.2%) whereas more Spanish-speakers indicated that at the time point they selected, a “life or a human exists” (36.8% v. 43.2%) as a rationale. Assessing public attitudes regarding government restrictions and protections for abortion is imperative in a post-Dobbs landscape since public opinion may influence state-level abortion legislation through elections and ballot initiatives, which, in turn, shapes reproductive healthcare and abortion access.