ABORTION VOLUME IN WESTERN PENNSYLVANIA BEFORE AND AFTER DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION

Objectives

We compared the number and characteristics of abortions in two practice settings in western Pennsylvania before and after Dobbs v Jackson Women’s Health Organization.

Methods

We conducted a retrospective cohort study of all abortions performed at an academic medical center (in-hospital) and a freestanding abortion clinic (out-of-hospital) between July 1, 2021 and May 31, 2023. We collected data on total number of abortions, gestational duration, proportion performed in the second trimester, type of abortion, and patient age and state of residence. We compared abortions between July 2021 and May 2022 (pre-Dobbs) with those between July 2022 and May 2023 (post-Dobbs) using t tests, Mann-Whitney U tests, and chi-square tests. We repeated the analysis stratifying by site.

Results

The total number of abortions across the two sites was 3,114 pre-Dobbs and 3,153 post-Dobbs. Post-Dobbs in-hospital abortions had a lower median gestational duration than did those pre-Dobbs (9 vs. 12 weeks, p<0.01) and these patients were less likely to be from out-of-state (8.8% vs. 13.1%, p=0.04). In contrast, post-Dobbs out-of-hospital abortion patients had a higher median gestational duration than did those pre-Dobbs (9 vs. 8 weeks, p<0.01) and patients were more likely to be from out-of-state (26.6% vs. 16.3%, p<0.01).

Conclusions

Out-of-hospital abortions were more likely to be from out-of-state and occurred at later gestational ages post-Dobbs than pre-Dobbs, while the opposite trends were seen for in-hospital abortion patients. The differences between sites suggest that the burden of increased demand from out-of-state patients was disproportionately absorbed by community abortion providers.