RESTORING, PROTECTING, AND EXPANDING ABORTION ACCESS IN THE US: SEEKING CONSENSUS THROUGH THE DELPHI METHOD

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110586

S Pickering, M Manze, JV Lazarus, D Romero

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引用次数: 0

Abstract

Objectives

The Dobbs v Jackson Women’s Health Organization 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 (ie, 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 (ie, >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 (eg, the utility of boycotts in states with abortion bans).

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恢复、保护和扩大美国的堕胎机会：通过德尔菲法寻求共识

目标多布斯诉杰克逊妇女健康组织案的判决加剧了美国堕胎机会的不公平。我们召集了一个由临床、研究、政策、法律和宣传专家组成的多学科、地域多元化德尔菲小组，就建议采取的行动达成共识（即 67% 的一致意见）。根据古特马赫研究所的分类，专家小组（人数=85）制定了 25 项共识声明和 32 项行动建议，适用于堕胎机会受到保护、混合或限制的州。在堕胎机会受保护的州，主要建议（即 70% 的一致意见）是将堕胎纳入初级保健，并扩大临床服务以包括所有类型的堕胎。在允许混合堕胎的州，主要建议是为寻求堕胎的患者建立途径，游说医疗补助计划覆盖堕胎，扩大临床服务以包括所有类型的堕胎，并建立广泛的堕胎联盟。在限制堕胎机会的州，主要建议是打击选区划分和选民压制，对急诊室工作人员进行堕胎护理培训，建立防止定罪的保护措施，以及翻转州立法机构。它还强调了需要进行更具战略性讨论的领域（例如，在禁止堕胎的州抵制堕胎的效用）。

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

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.