"Trust Women": Characteristics of and learnings from patients of a Shield Law medication abortion practice in the United States.

IF 3.4 2区医学 Q1 DEMOGRAPHY

Perspectives on Sexual and Reproductive Health Pub Date : 2024-09-01 Epub Date: 2024-09-30 DOI:10.1111/psrh.12287

Angel M Foster, Alice Mark, Kyle J Drouillard, Maureen Paul, Susan Yanow, Sarah Shahi, Dipesh Suvarna, Andrea Peña

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Abstract

Introduction: The 2022 Massachusetts Shield Law protects telemedicine providers who care for abortion seekers in other states from criminal, civil, and licensure penalties. In this article we explore the characteristics of patients of The Massachusetts Medication Abortion Access Project (The MAP).

Methods: The MAP is an asynchronous telemedicine service that offers mifepristone/misoprostol to abortion seekers in all 50 states who are at or under 11 weeks pregnancy gestation on initial intake. The MAP charges USD250 using a pay-what-you-can model. We analyzed medical questionnaires and payments submitted by patients who received care from The MAP during its first 6 months of operations using descriptive statistics and for content and themes.

Results: From October 1, 2023-March 31, 2024, 1994 patients accessed care through The MAP. Almost all (n = 1973, 99%) identified as women/girls and about half (n = 984, 49%) were aged 20-29. The MAP cared for patients in 45 states; 84% (n = 1672) of these patients received pills in abortion ban or restricted southern states. Patients paid USD134.50 on average; 29% (n = 577) paid USD25 or less. Nearly two-thirds (n = 1293, 65%) received subsidized care; financial hardship featured prominently in patient comments.

Discussion: Considerable demand exists for medication abortion care from Shield Law providers. The MAP demonstrates that providers can trust women and other pregnancy capable people to decide for themselves whether to obtain medication abortion pills by mail and to pay what they can afford without being required to justify their need. Identifying ways to support Shield Law provision and further subsidize abortion care are needed.

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"信任妇女"：美国一家盾牌法药物流产诊所的特点和从病人身上学到的经验。

导言：2022 年《马萨诸塞州屏蔽法》保护为其他州寻求堕胎者提供护理的远程医疗服务提供者免受刑事、民事和执照处罚。本文将探讨马萨诸塞州药物流产项目（The MAP）患者的特征：MAP 是一项异步远程医疗服务，为全美 50 个州首次接诊的妊娠 11 周或 11 周以下的人工流产寻求者提供米非司酮/米索前列醇。MAP 采用现收现付模式，收费 250 美元。我们使用描述性统计方法分析了在 MAP 运营的前 6 个月中接受其治疗的患者提交的医疗调查问卷和付款情况，并分析了内容和主题：从 2023 年 10 月 1 日到 2024 年 3 月 31 日，共有 1994 名患者通过 MAP 接受了治疗。几乎所有患者（n = 1973，99%）都被认定为女性/女孩，约一半患者（n = 984，49%）的年龄在 20-29 岁之间。MAP 为 45 个州的患者提供护理；其中 84% （n = 1672）的患者在禁止或限制堕胎的南部各州接受了药片治疗。患者平均支付 134.50 美元；29%（n = 577）支付 25 美元或更少。近三分之二（n = 1293，65%）的患者接受了补贴护理；经济困难在患者评论中占据突出位置：讨论：盾牌法医疗服务提供者对药物流产护理有相当大的需求。MAP 表明，医疗服务提供者可以相信妇女和其他有怀孕能力的人能够自行决定是否通过邮寄方式获取药物流产药片，并支付他们能够负担的费用，而无需证明他们的需求。需要确定支持《保护法》规定和进一步补贴堕胎护理的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perspectives on Sexual and Reproductive Health Multiple-

CiteScore

5.10

自引率

3.40%

发文量

期刊介绍： Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.