RESUMO
OBJECTIVES: To determine the proportion of abortions provided to patients from Texas in New Mexico before and after the 2013 enactment of Texas House Bill 2 (HB2), an omnibus bill of abortion restrictions, and to compare the gestational ages at which Texans presented for abortion in New Mexico before and after HB2. STUDY DESIGN: We conducted a chart review of Texas and New Mexico patients obtaining an abortion in New Mexico abortion clinics before HB 2 was signed and implemented (time period 1: January 1, 2012 to December 31, 2012) and after HB 2 went into effect (time period 2: May 1, 2014 to April 30, 2015). We used random sampling of corresponding 7-day periods (by week number during the one-year sample) to obtain data until we reached the desired sample of at least 300 patients. We compared proportions of individuals from Texas obtaining abortions and the gestational age at which they presented in the two time periods. RESULTS: We abstracted data from 350 and 300 Texas and New Mexico patients, respectively. The proportion of procedures provided to women from Texas increased from 10 (3%) pre-HB2 to 43 (14%) post-HB2 (p < 0.0001). The proportion of procedures in Texas patients at 13 to ≤24 weeks increased from 1 of 29 (3%) pre-HB2 to 10 of 38 (26%) post-HB2 (p = 0.012). CONCLUSION: The proportion of Texans scheduling abortions in New Mexico within the first 24 weeks of gestation increased after passage of HB2. Restrictive legislation may force more people to travel across state lines to obtain abortion care. IMPLICATIONS: Patients residing in Texas and seeking abortion care in Texas experienced barriers to abortion care, likely related to restrictions imposed by HB2.
Assuntos
Aborto Induzido , Aborto Legal , Instituições de Assistência Ambulatorial , Feminino , Humanos , New Mexico , Gravidez , Texas , ViagemRESUMO
BACKGROUND: Between January and October 2016, 575 symptomatic confirmed cases of Zika virus infection were reported in the U.S. Virgin Islands (USVI). Zika virus infection during pregnancy can cause serious birth defects. Preventing unintended pregnancy among women who choose to delay or avoid pregnancy is a primary strategy to reduce these adverse outcomes. METHODS: A rapid assessment, using one men's and five women's focus groups (N = 43), was conducted to inform communication efforts to increase awareness of contraception as a means for preventing unintended pregnancy in the context of a Zika outbreak in the USVI. RESULTS: Findings showed that people of reproductive age were aware of the relationship between Zika virus infection during pregnancy and adverse birth outcomes. However, when discussing methods for prevention, participants did not include preventing unintended pregnancy as a strategy to reduce these adverse outcomes. When asked about family planning in the USVI, participants discussed that, for some, planning pregnancies is not common. Participants wanted communications about contraception to include available methods, side effects, costs, and safety. Optimal communication channels included social media and local spokespersons. Participants identified health care providers as a trusted information source. CONCLUSIONS: Findings from this assessment informed the design of a culturally appropriate communication strategy to raise awareness of the prevention of unintended pregnancy as a primary strategy to reduce Zika-related adverse birth outcomes in the USVI.