Sociodemographic Characteristics of Women Able to Obtain Medication Abortion Before and After Ohio's Law Requiring Use of the Food and Drug Administration Protocol.

Purpose: In 2011, a law went into effect in Ohio that regulates how abortion care providers can offer medication abortion to their patients. We sought to evaluate changes in sociodemographic characteristics of Ohio medication abortion patients before and after the implementation of this law. Methods: We used a retrospective cohort design, comparing characteristics of women obtaining a medication abortion at four abortion facilities before and after the law. We used chart data from January 2010 to January 2011 and February 2011 to October 2014. For any significant changes in sociodemographics found before and after the law, we used stratified cross-tabulations to disentangle whether they were likely related to the restricted gestational limit imposed by the law (lowered from 9 to 7 weeks gestation), or whether they were likely related to other burdens brought on by the law, such as increased costs and visits. Results: Women obtaining a medication abortion after the law were more likely to be older (p=0.01), have higher levels of education (p<0.001), be of white race (p<0.001), have private insurance (p=0.001), have no children (p=0.002), and reside in a higher income zip code (p=0.03). Both the reduced gestational limit and the increased costs and visits likely contributed to declines among black women and women with lower levels of education. The reduced gestational limit for medication abortion likely contributed to a decline among younger women and Medicaid recipient groups. The increased costs and visits imposed by the law likely contributed to the decline in medication abortion among women with no insurance and women with children. Conclusion: The lower gestational limit, higher cost, and time and travel burdens exacted by Ohio's medication abortion law were associated with disproportionate reductions in medication abortion among the most disadvantaged groups. The law was associated with reduced access among women who were younger, of black race, less educated, and in lower socioeconomic groups.

The seasonality of abortion in Kentucky.

OBJECTIVES: Abortion incidence is correlated with seasonal trends in conceptions and births. This retrospective review looks at monthly abortion incidence to detect a seasonal trend. STUDY DESIGN: Data on abortion incidence in 2012 were obtained from the Kentucky Department of Vital Statistics. A regression analysis was performed to detect differences in abortion annualized rates by month. RESULTS: A total of 3810 abortions analyzed showed a trend in abortion incidence peaking in February and March with 444 and 378 abortions per month, respectively, compared to a mean of 299 in other months (p<.001). This trend persisted for second-trimester abortions with 64 and 56 abortions per month in February and March, respectively, compared to a mean of 30 in other months (p<.001). CONCLUSION: The peak in first-trimester abortions correlate with the expected peaks of December conceptions. However, the same trend in second-trimester abortions suggests that women are delaying care.

Factors Associated with Infant Feeding Choices in the Adolescent Population.

BACKGROUND: Strong recommendations have been made for exclusive breastfeeding of infants for the first 6 months of life, with continuation throughout the first year. In an attempt to optimize support for breastfeeding, particular barriers in populations with decreased rates need to be analyzed. OBJECTIVE: This study aimed to determine if participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food voucher program, involvement of the infant's father, involvement of the adolescent mother's parents or other caregivers, and participation in early skin-to-skin contact after birth are associated with the decision to breastfeed or bottle feed among this adolescent population. METHODS: A retrospective chart review of 457 adolescent patients who delivered January 2010 through May 2013 at the University of Louisville Hospital was conducted. Nursing documentation was used to determine the patient's intention to breastfeed or bottle feed, participation in WIC, involvement of the infant's father, involvement of the patient's parents, and participation in early skin-to-skin contact after delivery. These factors were compared using Fisher exact test. RESULTS: Three hundred one adolescents reported a plan to breastfeed (65.9%) and 156 reported a plan to bottle feed (34.1%) when questioned pre-delivery. There was no significant difference between the groups with respect to WIC participation or involvement of the infant's father. The bottle-feeding group had a significantly higher percentage who reported parental involvement (80.1% vs 67.8%, P = .0059). The breastfeeding group had a significantly higher percentage who participated in early skin-to-skin contact after birth (74.5% vs 58.1%, P = .0064). CONCLUSION: Involvement of the adolescent mothers' parents or caregivers was associated with the decision to bottle feed. Participation in early skin-to-skin contact after birth was associated with the decision to breastfeed.