The Shift From Criminalization to Legalization of Abortion in Argentina.

This Viewpoint discusses passage and implementation of Law 27.610, which legalized abortion in Argentina under certain circumstances, and examines the ongoing clinical issues and legal challenges to the law.

In re: the disposition of frozen embryos: 2022.

Debates regarding reproductive rights have waxed and waned since the early twentieth century. The current front-and-center debate draws this discussion into tighter focus. Challenges to reproductive rights, changes in definitions of personhood and a pending decision regarding Roe v Wade could change the management and options regarding the disposition of frozen embryos. This commentary outlines how changes in abortion law and reproductive rights could potentially impact the options available to both patients and clinics.

Disruptions to Abortion Care in Louisiana During Early Months of the COVID-19 Pandemic.

Objectives. To examine changes in abortions in Louisiana before and after the COVID-19 pandemic onset and assess whether variations in abortion service availability during this time might explain observed changes. Methods. We collected monthly service data from abortion clinics in Louisiana and neighboring states among Louisiana residents (January 2018‒May 2020) and assessed changes in abortions following pandemic onset. We conducted mystery client calls to 30 abortion clinics in Louisiana and neighboring states (April‒July 2020) and examined the percentage of open and scheduling clinics and median waits. Results. The number of abortions per month among Louisiana residents in Louisiana clinics decreased 31% (incidence rate ratio = 0.69; 95% confidence interval [CI] = 0.59, 0.79) from before to after pandemic onset, while the odds of having a second-trimester abortion increased (adjusted odds ratio [AOR] = 1.91; 95% CI = 1.10, 3.33). The decrease was not offset by an increase in out-of-state abortions. In Louisiana, only 1 or 2 (of 3) clinics were open (with a median wait > 2 weeks) through early May. Conclusions. The COVID-19 pandemic onset was associated with a significant decrease in the number of abortions and increase in the proportion of abortions provided in the second trimester among Louisiana residents. These changes followed service disruptions.

Abortion Access in Ohio's Changing Legislative Context, 2010-2018.

Objectives. To examine abortion utilization in Ohio from 2010 to 2018, a period when more than 15 abortion-related laws became effective.Methods. We evaluated changes in abortion rates and ratios examining gestation, geographic distribution, and abortion method in Ohio from 2010 to 2018. We used data from Ohio's Office of Vital Statistics, the Centers for Disease Control and Prevention's Abortion Surveillance Reports, the American Community Survey, and Ohio's Public Health Data Warehouse.Results. During 2010 through 2018, abortion rates declined similarly in Ohio, the Midwest, and the United States. In Ohio, the proportion of early first trimester abortions decreased; the proportion of abortions increased in nearly every later gestation category. Abortion ratios decreased sharply in most rural counties. When clinics closed, abortion ratios dropped in nearby counties.Conclusions. More Ohioans had abortions later in the first trimester, compared with national patterns, suggesting delays to care. Steeper decreases in abortion ratios in rural versus urban counties suggest geographic inequity in abortion access.Public Health Implications. Policies restricting abortion access in Ohio co-occur with delays to care and increasing geographic inequities. Restrictive policies do not improve reproductive health.

Guía para la interrupción voluntaria del embarazo (IVE) / Guidelines on termination of pregnancy

No disponible

Trends in nonresident abortion rates in New York City from 2005 to 2015: a time series analysis.

OBJECTIVES: To examine trends and utilization patterns of NYC abortion services by nonresidents since growing abortion restrictions across many states could drive women to seek care in less restrictive jurisdictions including NYC. STUDY DESIGN: We used data from Induced Termination of Pregnancy certificates filed with the NYC Department of Health and Mental Hygiene in 2005-2015. An autoregressive integrated moving average (ARIMA) model was fit to the monthly nonresident abortion rate time series. Pearson's χ2 tests determined associations between women's residence and other variables. RESULTS: During 2005-2015, 885,816 abortions were reported in NYC, with 76,990 (8.7%) among nonresidents; 50,211 (65.2%) nonresidents lived in other New York State counties. The NYC abortion rate declined from 49.4 per 1000 women 15-44 in 2005 to 32.7 in 2015, while the nonresident rate showed minimal change from 0.12 per 1000 US women 15-44 in 2005 to 0.10 in 2015. ARIMA(0,1,1)(0,0,1) [12] fit the time series indicating minimal monthly changes in nonresident rates reflecting seasonal patterns and shorter-term dependencies between successive observations. Nonresidents differed from residents in all investigated variables including terminating at 20+ weeks (9.0% vs. 2.5%, p<.001) and having procedural methods (87.2% vs. 82.2%, p<.001). CONCLUSIONS: Nonresidents constituted few abortion patients in NYC with minimal change in nonresident rates in 2005-2015. Nonresidents more often sought later-term abortions and more complicated procedures posing greater associated costs/risks. Monitoring nonresident abortion trends and utilization patterns is valuable for planning local service delivery particularly in jurisdictions committed to providing comprehensive women's healthcare where nonresidents may increasingly seek abortions. IMPLICATIONS: While we found limited change in nonresident abortion rates in NYC in 2005-2015, other jurisdictions bordering more restrictive states could show different results and should consider conducting similar research. Such analyses are important in jurisdictions committed to providing comprehensive women's healthcare where nonresidents may increasingly seek abortions in the future.

US trends in abortion and preterm birth.

BACKGROUND: A recent large meta-analysis concluded that prior surgical abortion was an independent risk factor for spontaneous preterm birth (PTB), while they found no significant correlation between PTB and medical abortion. OBJECTIVE: To evaluate the potential impact of changes in US abortion rates and practices on US incidence of PTB rate. STUDY DESIGN: This was an epidemiologic analysis of legal abortion and PTB data in the USA from 2003 to 2012. Birth data (annual total birth, annual number and incidence of PTB, defined as PTB <37 weeks) are from National Vital Statistics Reports from the National Center for Health Statistics, Center of Disease Control and Prevention (CDC). Abortion data were collected using Abortion Surveillance provided by the CDC. Abortion incidence was reported overall, and by type: surgical, medical method and procedures reported as "other" such as intrauterine instillation and hysterectomy/hysterotomy. To test for the trend of abortion and of PTB over time, we used the chi-squared test for trend. The primary outcome of our study was the correlation trend analysis between abortion rate and PTB rate. Pearson correlation test was used. A two-tailed p value of 0.05 or less was considered significant. RESULTS: From 2003 to 2012 there were 41 206 315 births in USA, of which 5 042 982 (12.2%) were <37 weeks. The PTB rate declined significantly from 12.3% in 2003 to 11.5% in 2012 (p value test for trend <.04). Out of the 6 122 649 legal abortions, reported by type of procedure, performed from 2003 to 2012 in USA, 5 132 789 were surgical abortion (82.8%) and 860 288 (14.0%) were medical. Chi-squared test for trend showed that the rate of surgical abortion significantly decreased from 88.9 to 78.0% (p < .01) while the rate of medical abortion significantly increased from 7.9 to 21.9% (p < .01) from 2003 to 2012, respectively. The rate of PTB was correlated with the rate of medical abortion (p = .01) and of surgical abortion (p = .02) over time. The higher the surgical abortion rate, the higher the incidence of PTB (Pearson correlation 0.712); the higher the medical abortion rate, the lower the incidence of PTB (Pearson correlation -0.731). CONCLUSION: Recent changes in abortion practices may be associated with the current decrease in US incidence of PTB. Further study on the effect of surgical versus medical abortion is warranted regarding a possible effect on the incidence of PTB.

Update on abortion policy.

PURPOSE OF REVIEW: To review the status of antiabortion restrictions enacted over the last 5 years in the United States and their impact on abortion services. RECENT FINDINGS: In recent years, there has been an alarming rise in the number of antiabortion laws enacted across the United States. In total, various states in the union enacted 334 abortion restrictions from 2011 to July 2016, accounting for 30% of all abortion restrictions since the legalization of abortion in 1973. Data confirm, however, that more liberal abortion laws do not increase the number of abortions, but instead greatly decrease the number of abortion-related deaths. Several countries including Romania, South Africa and Nepal have seen dramatic decreases in maternal mortality after liberalization of abortion laws, without an increase in the total number of abortions. In the United States, abortions are incredibly safe with very low rates of complications and a mortality rate of 0.7 per 100 000 women. With increasing abortion restrictions, maternal mortality in the United States can be expected to rise over the coming years, as has been observed in Texas recently. SUMMARY: Liberalization of abortion laws saves women's lives. The rising number of antiabortion restrictions will ultimately harm women and their families.

Ready, Willing, and Able? Impediments to the Onset of Marital Fertility Decline in the United States.

This study relies on IPUMS samples of the 1850, 1860, 1870, and 1880 censuses, aggregate census data, and the timing of state laws criminalizing abortion to construct regional estimates of marital fertility in the United States and estimate correlates of marital fertility. The results show a significant lag between the onset of marital fertility decline in the nation's northeastern census divisions and its onset in western and southern census divisions. Empirical models indicate the presence of cultural, economic, and legal impediments to the diffusion of marital fertility control and illustrate the need for more inclusive models of fertility decline.

The impact of a liberalisation law on legally induced abortion hospitalisations.

OBJECTIVES: Legal abortion based purely in maternal option without fetal/maternal pathology was liberalised in Portugal in 2007 and since then abortion rates have increased substantially. The aim of this paper was to study the impact of the liberalisation of abortion by maternal request on total legal abortion related hospitalisation trends. STUDY DESIGN: We considered hospitalisations of legal abortion (ICD-9-CM codes 635.x) with discharges from 2000 to 2014. Data was obtained from a Portuguese administrative database, which contains all registered public hospitalisations in mainland Portugal. Performed legal abortions during the same period were obtained from INE (National Statistics Institute). Hospitalisations per abortion were calculated by dividing the number of legal abortions hospitalisations per the number of legal abortions, mean ages, number of hospitalisations per age group, complications, admission type and length of stay were also analysed, throughout the study period. RESULTS: Hospitalisations rose during the study period, (from 618 episodes in 2000 to 1,259 in 2014, with a peak of 1,603 in 2010). Since the liberalisation law was passed there was a significant decrease in the number of hospitalisations per abortion: from 1.07 in 2000 to 0.11 in 2014 (p<0.001). Furthermore, the mean age maintained stable since liberalisation (30.8 years before 2007 and 31.0 after). Abortion related hospitalisations are more frequent in women aged 25-39. A significant decrease from the emergent to the scheduled type of admission occurred from 2000 to 2014 (from 83.5% to 56.7% of emergent admissions) (p<0.001). Complications remained stable between 2000 and 2014 and delayed or excessive haemorrhage was the most frequent (4.6%). CONCLUSIONS: Since the liberalisation, hospitalisations per abortion have decreased, reflecting the major impact that the liberalisation of legal abortion by maternal request had on abortion trends nationwide. Before the liberalisation, each abortion led to approximately one hospitalisation while after the liberalisation this trend shifted to approximately 10% of the number of abortions. Legal abortion related hospitalisations are more frequent in women aged between 25 and 39 years old, an older age group when compared to the one registered in all cases of legal abortions, reflecting the differences between those hospitalised and those who are not. Our study shows the impact that legal abortion by maternal request liberalisation law can bring to abortion and to hospitalisation trends.

Change over time in attitudes about abortion laws relative to recent restrictions in Texas.

OBJECTIVE: Over the past 5 years, Texas has become a hotbed of debate on abortion rights and restrictions. Legislation in 2011 and 2013 made it more difficult for women to obtain abortions and for clinics to provide the procedure, laws which have resulted in practical obstacles and the closure of clinics. Less is known about whether that political activity has extended to public opinion on abortion in Texas, especially in the national context of increasing partisanship. STUDY DESIGN: Data from the cross-sectional Houston Area Survey (HAS; n=4856) were used to compare attitudes about abortion at three time points: in 2010 before the major waves of legislation, in 2012 after the 2011 legislation, and in 2014 after the 2013 legislation. Logistic regressions estimated support for legal abortion over time, after adjusting for personal characteristics, views on other social issues, religiosity, political party identification and political ideology. RESULTS: At all three time points studied, slightly more than half of Houstonians supported legal abortion for any reason a woman wanted to obtain one. Compared to 2010, support was significantly higher in 2012 and 2014, whereas the decline in support between 2012 and 2014 was not statistically significant after adjusting for religiosity and politics. CONCLUSIONS: This study identified increased public support for legal abortion following the Texas state legislature's restrictive laws in 2011 and 2013. IMPLICATIONS: As the Texas legislature increasingly restricts access to abortion, residents of the state's largest and most diverse city do not hold attitudes in line with those restrictions. Clinicians may thus have more public support for their services than the divided political climate would suggest.

[['Love them Both': Abortion in a Globalized World].] / "Amali Entrambi": L'Aborto ai Tempi Della Globalizzazione.

This article explores the origins and the development of women-protective anti-abortion arguments in a globalized world. Unlike fetus-base pro- life arguments, women protective ones focus on gender stereotypes and on the theory of gender complementarity. The article traces the influence of US conservative groups in spreading such arguments beyond the US borders, so that in today's globalized world, womnen-protective arguments have become central in abortion and contraception related legislation and litigation in the US, Europe and Russia. The article points to the dangers of the women-protective anti-abortion strategy, which aims at disempowering women, by denying them agency and control over reproduction, resulting in a direct challenge to gender equality.

Malentendidos sobre el efecto de la legalización del aborto / Misunderstandings about the effect of legalizing abortion

Las leyes sobre aborto son liberales en la mayor parte de los países desarrollados y muy restrictivas en países en desarrollo, particularmente América Latina, con dos excepciones. Organismos internacionales de Salud y Derechos Humanos promueven un mayor acceso al aborto seguro por su efecto inmediato de reducción de morbilidad y mortalidad materna. A pesar de eso las leyes permanecen muy restrictivas en la mayor parte de los países de América Latina, donde prevalece el concepto errado de que liberalizar la ley va a llevar a un aumento en el número de abortos, lo que casi todos prefieren evitar. Ese es un importante malentendido, porque las evidencias son que no hay menos aborto donde las leyes son restrictivas y no aumentan los abortos cuando las leyes se hacen más liberales. Así mismo, se cree que la mayor parte de la población está contra liberalizar la ley, pero preguntando mejor se descubre que la mayor parte está contra castigar a la mujer que aborta. Pero, el principal malentendido es creer que hay personas æa favor del abortoÆ, en circunstancia que ni siquiera a la mujer que se provoca el aborto le gusta abortar. La diferencia está en pensar que prohibiendo se soluciona el problema, o aceptar las evidencias que muestran que aumentando el acceso al aborto seguro no solo reduce el sufrimiento y la muerte, sino contribuye a reducir los abortos...

Abortion laws are generally liberal in most of the developed countries and restrictive in developing countries, particularly in Latin America, with two exceptions. International health and human rights organizations promote broader access to safe abortion based on its effectiveness in immediate reduction of maternal morbidity and mortality. Laws remain restrictive in Latin America because of the erroneous concept that liberalization of the law would increase the number of induced abortions, something most people would not like. This is a crucial misunderstanding because evidence shows abortions are not less in countries with restrictive laws and number of abortions does not increase following liberalization of the law. It is also believed that most people are against liberalization of the law, but further inquiry reveals that most people are against punishing women who have abortions. The main misunderstanding is the belief that there are people ôin favor of abortionõ, while even women who abort do not like abortion. The real difference is that there are people who believe that keeping restrictive laws can prevent abortion and others accept evidence which shows that increasing access to safe abortion not only reduces suffering and deaths but contributes to reduce induced abortions...