ABORTION PROVISION AT NEW YORK STATE REGIONAL PERINATAL CENTERS FOLLOWING IMPLEMENTATION OF THE REPRODUCTIVE HEALTH ACT

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110587

GR Krishna, JE Kohn, R Bleck, CL Westhoff

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引用次数: 0

Abstract

Objectives

Signed in 2019, the Reproductive Health Act protects abortion in New York State after 24 weeks. This study describes implementation of the Reproductive Health Act among regional perinatal centers (RPCs)—tertiary referral centers for complex pregnancies which may care for patients seeking abortion later in pregnancy. A secondary objective was to identify barriers to and facilitators of policy implementation.

Methods

We recruited clinicians from the 17 New York RPCs, including Family Planning, Maternal-Fetal Medicine (MFM), and Genetic Counseling specialists. Respondents completed an online survey. We invited respondents to complete an in-depth interview. We calculated descriptive statistics to characterize the study population and summarize survey responses. We analyzed qualitative interviews using thematic analysis.

Results

Twenty-nine respondents completed the survey, representing 16 of 17 RPCs. Seventeen respondents, representing 11 RPCs, completed an interview. Seventy-nine percent of respondents reported barriers to providing abortion after 24 weeks from last menstrual period (LMP). Fewer (62%) reported barriers to providing abortion after 24 weeks for maternal or fetal indications. The most commonly-reported barriers in the survey results were staff resistance and institutional policy. During interviews, respondents identified staff resistance, restrictive institutional policies, and lack of clarity around policy as barriers to providing abortion care, while highlighting advocates and collaboration within their institutions as facilitators to implementation.

Conclusions

RPCs in New York State face barriers in providing abortion, especially after 24 weeks, even though they are ideally situated to provide such care. These barriers exist despite the legality of abortion after 24 weeks and policy efforts to expand access.

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纽约州地区围产中心在实施《生殖健康法》后提供堕胎服务的情况

目标2019 年签署的《生殖健康法案》保护纽约州 24 周后的堕胎。本研究介绍了《生殖健康法案》在地区围产中心（RPCs）--复杂妊娠的三级转诊中心--中的实施情况，这些中心可能会照顾在妊娠晚期寻求堕胎的患者。我们招募了来自纽约 17 家地区围产中心的临床医生，包括计划生育、母胎医学 (MFM) 和遗传咨询专家。受访者完成了一份在线调查。我们邀请受访者完成深度访谈。我们计算了描述性统计数据，以描述研究人群的特征并总结调查回复。我们使用主题分析法对定性访谈进行了分析。结果29 位受访者完成了调查，代表了 17 个区域协调中心中的 16 个。代表 11 个区域协调中心的 17 名受访者完成了访谈。79%的受访者表示，在距末次月经期（LMP）24 周后提供人工流产服务存在障碍。较少受访者（62%）报告了因母体或胎儿原因而在 24 周后提供人工流产的障碍。调查结果中最常报告的障碍是工作人员的阻力和机构政策。在访谈中，受访者认为员工抵制、限制性机构政策和政策不明确是提供人工流产护理的障碍，同时强调机构内的倡导者和合作是实施的促进因素。尽管 24 周后堕胎是合法的，而且政策也在努力扩大堕胎机会，但这些障碍依然存在。

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.