Who receives abortions at 6- or 16-weeks’ gestation? A case study from Ohio

TL;DR

This study examines who gets abortions at specific gestation stages in Ohio, finding disparities linked to race, education, and age.

Contribution

The study identifies demographic patterns in abortion access under gestation-based bans, highlighting inequities for marginalized groups.

Findings

Black and non-White patients had lower odds of early abortions compared to White patients.

College-educated and older patients were more likely to have abortions before 6 weeks.

Out-of-state patients had higher odds of later abortions, suggesting travel barriers.

Abstract

In the United States, states enacted gestation-based bans following the US Supreme Court case Dobbs v. Jackson Women's Health Organization. We examined how patient characteristics differed by gestation at abortion. We used data from a 20% random sample of charts at three Ohio abortion facilities for patients who visited 2014–2018. We used logistic regression to calculate unadjusted and adjusted odds of abortion before 6 weeks and at 16 weeks or after, based on sociodemographic characteristics. We analysed 4,926 charts. Black patients and those of another race had lower odds of abortion before 6 weeks compared to White patients (odds ratio [OR]: 0.30, CI: 0.21–0.42, p < 0.001; and OR: 0.64, CI: 0.41–0.995, p = 0.048, respectively), as did those from out-of-state (OR: 0.22, CI: 0.11–0. 42, p < 0.001). Patients aged 30 and older (compared to those under 25; OR: 1.66, CI: 1.25–2.21, p < 0.001), those with a college degree (OR: 2.60, CI: 2.03–3.33, p < 0.001), married patients (OR: 1.77, CI: 1.27–2.46, p < 0.001), and those without children (OR: 1.29, CI: 1.01–1.66, p = 0.041) had higher odds. Patients with a college degree and those without children had lower odds of abortion at 16 weeks or after (OR: 0.67, CI: 0.49–0.91, p = 0.010; and OR: 0.75, CI: 0.58–0.97, p = 0.030, respectively), while those from out-of-state had higher odds (OR: 2.18, CI: 1.64–2.90, p < 0.001). Laws restricting access to abortion create inequitable harms to pregnant people, with particular impacts on patients of colour, those with less education, younger patients, and parents. As states restrict abortion, accessing timely care may become particularly challenging for those experiencing systemic discrimination.

Many states have passed laws that ban abortions after a specific number of weeks of pregnancy. In this study, we wanted to learn who might lose access to abortion under these types of bans. To do so, we compared patients who had abortions before six weeks of pregnancy to those who had them at six weeks or after. We also compared patients who had abortions before 16 weeks of pregnancy to those who had them at 16 weeks or after. Our data came from looking through medical charts from three abortion facilities in Ohio for patients who sought care between 2014 and 2018. We found that people who were more likely to have abortions before six weeks were White, older, college-educated, married, not parents, and from Ohio. Similarly, people who were more likely to have abortions before 16 weeks were college-educated, not parents, and from Ohio. States that ban abortion at specific weeks of pregnancy will make accessing timely abortion care more challenging, especially for members of marginalised groups.

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