Heidi Moseson, Caitlin McKenna, Bria Goode, Alexandra Wollum, Meg Sasse Stern, Tracey A Wilkinson
{"title":"Financial Barriers Are Associated With Self-Managed Abortion in Indiana: Results From a Mixed-Methods Study in 2021-2022.","authors":"Heidi Moseson, Caitlin McKenna, Bria Goode, Alexandra Wollum, Meg Sasse Stern, Tracey A Wilkinson","doi":"10.1111/psrh.70008","DOIUrl":"https://doi.org/10.1111/psrh.70008","url":null,"abstract":"<p><strong>Objectives: </strong>To measure knowledge of and experiences with self-managed abortion among abortion seekers in Indiana before the Supreme Court decision in Dobbs v. Jackson Women's Health Organization (Dobbs).</p><p><strong>Study design: </strong>Between June 2021 and April 2022, we recruited a non-probability sample of Indiana residents of any age who were currently or recently pregnant and considering abortion via online advertisements, referrals from abortion funds, and flyers in abortion clinics. Participants completed two online surveys 1 month apart, and a subset completed in-depth interviews. We conducted descriptive and regression analyses of characteristics, methods, motivations, and knowledge of self-managed abortion.</p><p><strong>Results: </strong>Among 434 total participants, 33 (7.6%, 95% CI: 5.5%-10.5%) reported a self-managed abortion attempt for their current/recent pregnancy; these participants were younger, less likely to be parents, more likely to be pregnant for the first time, and more likely to identify as a sexual and/or gender minority person than were participants who did not attempt to self-manage. Participants cited unaffordability of clinician-supported abortion care (n = 16/33, 49%) as the most common reason for attempting to self-manage. Those who reported challenges paying for abortion were three times more likely to attempt a self-managed abortion than those who did not (aRR: 3.0, 95% CI: 1.1, 8.2). Interviews (n = 40) highlighted low awareness of self-managed medication abortion.</p><p><strong>Conclusions: </strong>Among people who faced financial barriers to clinician-supported abortion care in Indiana, financial distress motivated some residents to self-manage abortions. In the further restricted post-Dobbs period, financial support to obtain clinician-supported care and trusted, accessible information on safe and effective self-managed abortion options are imperative so that Indiana residents can access abortion care in accordance with their preferences.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stratified Access and Experiences of Maternal Health Care in the United States-Mexico Border Region.","authors":"Carina Heckert, Andrea Daniella Mata","doi":"10.1111/psrh.70007","DOIUrl":"https://doi.org/10.1111/psrh.70007","url":null,"abstract":"<p><strong>Introduction: </strong>The United States (US) state of Texas uses two publicly funded programs to cover pregnant people-Medicaid for Pregnant Women and Children's Health Insurance Program (CHIP) Perinatal. While Medicaid offers more comprehensive coverage than CHIP Perinatal, it only includes US citizens and legally qualified residents. This tiered access to care, determined primarily by immigration status, generates stratified access. This paper explores how stratified access factors into reproductive experiences.</p><p><strong>Methodology: </strong>Thirty-two pregnant and postpartum women who identified as first- or second-generation immigrants and had public insurance or no insurance coverage participated in a semi-structured in-depth interview. Interview questions explored topics related to immigration and border policies more broadly. This piece analyzes themes that emerged in relation to the type of healthcare coverage participants were able to access during pregnancy.</p><p><strong>Results: </strong>Participants had a range of immigration statuses that factored into their eligibility for health programs. During pregnancy, 12 had CHIP Perinatal, 15 had Medicaid, and five had no coverage. Key themes shaping experiences of care included bureaucratic barriers in navigating health programs, inadequate coverage that reinforced health vulnerabilities, and feelings of limited autonomy.</p><p><strong>Discussion: </strong>Women's narratives highlight the ways immigration status generates barriers to receiving health care coverage, including coverage for programs that individuals are entitled to regardless of immigration status. The type of coverage that a pregnant woman has dictates how comprehensive her care is and the degree to which she experiences coverage gaps outside of pregnancy.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sync or Swim: Navigating the Tides of Menstrual Cycle Messaging on TikTok.","authors":"Emily Pfender, Claire Wanzer, Lotte Mikkers, Amy Bleakley","doi":"10.1111/psrh.70004","DOIUrl":"https://doi.org/10.1111/psrh.70004","url":null,"abstract":"<p><strong>Objective: </strong>To understand messaging about cycle syncing on TikTok, a trend that involves harmonizing daily activities and self-care rituals with various stages of the menstrual cycle.</p><p><strong>Methods: </strong>We conducted a quantitative content analysis of TikTok videos (N = 100). In January 2023, we collected TikTok videos from content creators using the hashtag #cyclesyncing.</p><p><strong>Results: </strong>About one-third of creators provided credentials. However, very few mentioned scientific evidence. More than half of the creators recommended aligning diet and exercise with the four menstrual cycle phases. Creators specifically recommended diets and exercises for each menstrual cycle phase.</p><p><strong>Conclusion: </strong>Cycle syncing content on TikTok oversimplifies a complex literature involving tailoring diet and exercise to the menstrual cycle. Our findings also have implications for previous research pointing to negative discourse about hormonal contraception on social media and problematic messaging about women's reproductive health. More expert voices surrounding women's reproductive health are needed in the evolving social media landscape.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sterilization, Infecundity, and Reproductive Autonomy in Rural, Suburban, and Urban America: Results From a National Survey.","authors":"Shelley Clark, Zoe Levy","doi":"10.1111/psrh.70006","DOIUrl":"10.1111/psrh.70006","url":null,"abstract":"<p><strong>Objective: </strong>Rural women are significantly more likely than urban women to be sterilized. This study aims to understand why rural women depend so heavily on this method of fertility control, whether they are more likely than suburban and urban women to desire sterilization reversal, and the impact of female sterilization on rural women's ability to achieve their fertility goals.</p><p><strong>Methods: </strong>Data from 10,081 sexually active women aged 15 to 49, who participated in the National Survey of Family Growth (2015-2019), were analyzed using binary and multinomial logistic regression analyses. Unadjusted and adjusted predicted probabilities were calculated to estimate the prevalence of (1) female sterilization, (2) desire for sterilization reversal or wanting a(nother) child if sterilized, and (3) unwanted infecundity among rural, suburban, and urban women.</p><p><strong>Results: </strong>Rural women (24.2%) are substantially more likely than suburban (15.3%) or urban (13.9%) women to receive tubal ligation. These disparities are not explained by women's demographic, reproductive, religious, and socioeconomic characteristics. Rural women who are sterilized are not more likely than suburban or urban women to desire sterilization reversal or to want to have (more) children. However, because more rural women rely on tubal ligation, a significantly higher fraction of rural women (34.8%) than urban women (23.8%) who want to have a(nother) child are infecund. Roughly, 40% of infecund rural women who wish to conceive had tubal ligation.</p><p><strong>Conclusions: </strong>Limited contraceptive choice undermines rural women's ability to conceive wanted births. These results highlight another important reason for expanded reproductive health care in rural America.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"72-84"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel N Feltman, Steven R Lewis, Nathan E Thompson
{"title":"Accuracy and Misleadingness of Anatomical and Embryological Statements in State-Level Abortion Ban Legislation in the United States.","authors":"Rachel N Feltman, Steven R Lewis, Nathan E Thompson","doi":"10.1111/psrh.70001","DOIUrl":"10.1111/psrh.70001","url":null,"abstract":"<p><strong>Objective: </strong>In the last 15 years, the United States has seen a surge in anti-abortion legislation enacted at the state level. Many of these pieces of legislation utilize anatomical and embryological details to justify the necessity of abortion bans. In this study, we evaluated the level to which these statements are accurate and/or misleading, if at all, as determined by experts in anatomy and embryology.</p><p><strong>Methods: </strong>Experts evaluated statements of anatomical and embryological fact included in Legislative Findings (or equivalent) sections of state-level abortion ban legislation passed between January 2016 and January 2023 on their level of accuracy and misleadingness. We investigated 56 pieces of legislation from 23 states, which resulted in 57 testable statements common to 13 pieces of legislation across 12 states. Forty-one experts in anatomy and embryology rated each statement from 1 (completely inaccurate/misleading) to 5 (completely accurate/non-misleading).</p><p><strong>Results: </strong>Mean accuracy for all 57 statements was 3.0 ± 1.2 (range: 1.4-4.3) and the overall level of misleadingness was 2.5 ± 1.2 (range: 1.3-3.8).</p><p><strong>Conclusion: </strong>All 57 statements were significantly different from a null expectation of completely accurate and completely non-misleading. Statements made about anatomy and embryology aim to justify abortion bans but contain, to varying extents, inaccurate and misleading information, thereby contributing to the detrimental effects of restrictive abortion legislation on the health and well-being of pregnancy-capable people.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"17-24"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tagrid Jar-Allah, Mina Edalat, Viola Nyman, Ian Milsom, Kristina Gemzell-Danielsson, Johanna Rydelius, Helena Hognert
{"title":"Perspectives on Abortion Services, the Pre-Abortion Visit, and Telemedicine Abortion: A Qualitative Study in Sweden.","authors":"Tagrid Jar-Allah, Mina Edalat, Viola Nyman, Ian Milsom, Kristina Gemzell-Danielsson, Johanna Rydelius, Helena Hognert","doi":"10.1111/psrh.12290","DOIUrl":"10.1111/psrh.12290","url":null,"abstract":"<p><strong>Context: </strong>According to Swedish law, abortion treatment should be carried out at an approved healthcare facility. All persons seeking medication abortions are obliged to attend an in-person visit, which includes a gynecological examination, an ultrasound scan, and administration of mifepristone at a hospital/clinic. However, some countries have implemented telemedicine abortion services without the requirement of in-person visits during and after the COVID-19 pandemic. The aim of this study is to (1) describe abortion seekers' experience of currently available abortion care; (2) explore abortion seekers' suggestions for improving medication abortion care; and (3) explore abortion seekers' views on an abortion care model that omits an in-person appointment and examination.</p><p><strong>Methods: </strong>We interviewed 20 participants who sought early medication abortion at Sahlgrenska University Hospital, Gothenburg, Sweden, from March to April 2023. Systematic text-condensation of qualitative semi-structured interviews was used to explore abortion seekers' experience of the pre-abortion visit, including the gynecological and ultrasound examinations, thoughts about abortion care services, and telemedicine abortion.</p><p><strong>Results: </strong>Three main findings emerged (1) The participants found it easy to contact the abortion clinic, but experienced undesired waiting time (2) Most participants appreciated the gynecological examination, but some found it distressing and uncomfortable (3) Participants considered telemedicine and taking mifepristone at home to be a good option in addition to in-person abortion care.</p><p><strong>Conclusion: </strong>Offering both telemedicine and in-person consultations enhances abortion seekers' autonomy, reduces delays, and minimizes stress in abortion care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"36-44"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail Newby-Kew, Jonathan M Snowden, Anne Valentine, Ilhom Akobirshoev, Monika Mitra, Willi Horner-Johnson
{"title":"Pregnancy Intendedness by Presence and Extent of Disability in the USA, 2019-2020.","authors":"Abigail Newby-Kew, Jonathan M Snowden, Anne Valentine, Ilhom Akobirshoev, Monika Mitra, Willi Horner-Johnson","doi":"10.1111/psrh.12292","DOIUrl":"10.1111/psrh.12292","url":null,"abstract":"<p><strong>Context: </strong>Over 40% of pregnancies in the United States are unintended. Women with unintended pregnancies may be less likely to receive timely prenatal care and engage in healthy behaviors immediately before and during pregnancy. Limited research suggests that women with disabilities are more likely to have an unintended pregnancy, but to date no studies have assessed whether intendedness varies by extent of disability.</p><p><strong>Methods: </strong>We analyzed 2019-2020 PRAMS data from 22 sites that included the Washington Group Short Set of Questions on Disability (n = 37,832). We examined associations of extent of disability (none, some difficulty, or a lot of difficulty) with pregnancy intendedness (classified as intended, mistimed, unwanted, or unsure). We used multinomial logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) while controlling for sociodemographic characteristics.</p><p><strong>Results: </strong>Overall, 60.1% of pregnancies were intended, 18.2% mistimed, 6.4% unwanted, and 15.3% unsure. Compared to respondents with no difficulty, respondents with some difficulty or a lot of difficulty were more likely to report a mistimed pregnancy (aOR = 1.55, 95%CI 1.40,1.71; aOR = 1.62, 95%CI 1.34,1.95), an unwanted pregnancy (aOR = 1.92, 95%CI 1.66,2.24; aOR = 2.20; 95%CI 1.72,2.82), and unsure intendedness (aOR = 1.61, 95%CI 1.45,1.79; aOR = 1.75, 95%CI 1.45,2.11), respectively.</p><p><strong>Conclusions: </strong>People with disabilities who give birth, regardless of extent of disability, had elevated odds of mistimed and unwanted pregnancy and of being unsure of their pregnancy intendedness. Our findings support the use of more inclusive measures of disability and emphasize the need for equitable reproductive healthcare that respects the childbearing potential and choices of individuals with disabilities.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"85-94"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"I Don't Really Agree With That:\" Canadians' Perspectives on the 14-Day Rule in Relation to Artificial Womb Technology.","authors":"Srishti Hukku, Lisa L Wynn, Angel M Foster","doi":"10.1111/psrh.70005","DOIUrl":"10.1111/psrh.70005","url":null,"abstract":"<p><strong>Introduction: </strong>Complete ectogenesis through artificial womb technology (AWT) would enable fertilization, embryonic development, and fetal development outside of the human body. In 2004, Canada's Assisted Human Reproduction Act established a 14-day legal limit on the in vitro cultivation of human embryos, stymying the domestic development of AWT. Given recent scientific advancements, we aimed to explore Canadians' perspectives on the 14-day rule and AWT development.</p><p><strong>Methods: </strong>In September 2020-February 2021, we conducted an online English-French survey and semi-structured in-depth interviews with a subset of respondents to solicit Canadian citizens' perspectives on AWT. We audio-recorded and transcribed the telephone/Zoom/Skype interviews and used ATLAS.ti to manage our data. We analyzed survey data using descriptive statistics and interviews for content and themes using inductive and deductive techniques.</p><p><strong>Results: </strong>We received 343 completed surveys and conducted 41 interviews. Although overall knowledge of AWT, in general, and the 14-day rule, in particular, was limited, our participants felt that AWT had the potential to improve lives. Participants also perceived the 14-day rule as an outdated limitation on technological progress and a barrier to AWT development. Participants suggested revisiting the legislation and emphasized centering science, technology, and medicine in any update.</p><p><strong>Discussion: </strong>In 2021, the International Society for Stem Cell Research released updated guidelines which recommended relaxing the 14-day rule, depending on the research objectives. Given the changing domestic and international landscape, Canadian policymakers should revisit the 14-day rule limit imposed by the Assisted Human Reproduction Act and seek input from Canadians when embarking on this reform process.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"104-113"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Montenegro, Julie Maier, Danny Valdez, Frederica Jackson, Wen-Juo Lo, Ronna Turner, Brandon Crawford, Kristen Jozkowski
{"title":"\"Distinct and Separate Issues\": Examining US Adults' Attitudes Toward Abortion During COVID-19.","authors":"María Montenegro, Julie Maier, Danny Valdez, Frederica Jackson, Wen-Juo Lo, Ronna Turner, Brandon Crawford, Kristen Jozkowski","doi":"10.1111/psrh.70002","DOIUrl":"10.1111/psrh.70002","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic reshaped people's healthcare experiences and access to healthcare, including abortion. In response to the COVID-19 outbreak, some policymakers claimed that abortion is a nonessential service and should be restricted. In contrast, other policymakers contended that abortion is time-sensitive essential healthcare, and access to it should be protected. These efforts put access to abortion into the public arena during the onset of the pandemic. We examined whether people perceived the pandemic changed their attitudes toward abortion and their rationale for whether their support for abortion increased, decreased, or remained the same.</p><p><strong>Method: </strong>We administered a web-based survey to US-based English and Spanish-speaking adults (n = 1583) to assess their abortion beliefs. Participants answered open and close-ended questions about abortion, including whether they believe the COVID-19 outbreak changed their views about abortion and why. Because our sample was not representative of the US population, we weighted the data and present weighted results.</p><p><strong>Results: </strong>As expected, most participants (91.7%) indicated that the COVID-19 outbreak did not change their abortion views. Many of these participants did not see a relationship between the COVID-19 pandemic and abortion. Participants who became more supportive (5.2%) cited well-being and financial concerns as reasons. Participants who became less supportive (3.1%) cited excessive death associated with the COVID-19 outbreak as their reason.</p><p><strong>Conclusion: </strong>Most participants perceived that the COVID-19 pandemic did not change their views about abortion, suggesting the pandemic may not be a context linked to abortion attitudes.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"8-16"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabel DoCampo, Rachel K Jones, Isaac Maddow-Zimet
{"title":"The Role of Medication Abortion Provision in US States Without Total Abortion Bans, 2023.","authors":"Isabel DoCampo, Rachel K Jones, Isaac Maddow-Zimet","doi":"10.1111/psrh.12294","DOIUrl":"10.1111/psrh.12294","url":null,"abstract":"<p><strong>Background: </strong>Medication abortion has accounted for an increasing share of abortions in the United States (US) since the Food and Drug Administration's approval of mifepristone in 2000. This study offers updated estimates of medication abortions provided within the formal healthcare system in 2023 in US states without total abortion bans as well as a discussion of recent trends in medication abortion provision.</p><p><strong>Methods: </strong>The Guttmacher Institute's Monthly Abortion Provision Study employs data from monthly samples of providers in a Bayesian hierarchical model to produce estimates of abortions provided within the formal healthcare system. We estimate the number and share of medication abortions provided in 2023 in states without total abortion bans and the share of abortions provided through telemedicine-only clinics.</p><p><strong>Results: </strong>Clinicians provided 648,500 medication abortions within the formal healthcare system in 2023 in states without total bans (90% uncertainty interval: 640,720-657,860), representing 63% of all abortions. Ten percent of all abortions were provided by telemedicine-only clinics. The number of medication abortions provided in US states without total abortion bans increased by 19% between 2019 and 2020, and by 32% between 2020 and 2023.</p><p><strong>Discussion: </strong>Medication abortion plays a critical role in the US abortion access landscape. Medication abortion provision has accelerated since 2019, likely due to COVID-era policies that facilitated the expansion of telemedicine medication abortion provision. This shift has created essential access for individuals navigating abortion bans and other barriers to care since the removal of federal abortion protections.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"3-7"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}