Abortion providers in the United States: expanding beyond obstetrics and gynecology.

In the years preceding the Dobbs v Jackson Women's Health Organization (2022) decision, there had been a shift in the demographics of abortion providers. Although most abortion providers were obstetricians-gynecologists, there had been a rapid increase in the number of internal medicine and family medicine physicians and advanced practice clinicians providing abortion care. As discourse about limiting abortion access has gained volume over the past few years, so have the number of legislative restrictions aimed at preventing people from seeking abortions. Among these are laws and policies targeted at reducing the number of providers and clinics providing abortion care, resulting in an absence of training, high case volume, and institutional restrictions. With the overturning of Roe v Wade, the landscape of abortion provision will continue to shift further. Action needs to be taken to expand the types of providers getting trained and providing abortions to ensure access for those seeking abortions.

Socioeconomic Analysis of the Surgical Management of Ectopic Pregnancies: An Analysis of the National Inpatient Sample.

STUDY OBJECTIVE: To identify racial and socioeconomic disparities in the surgical management of ectopic pregnancy. DESIGN: Retrospective study. The National Inpatient Sample was sampled from 2015 to 2017 for inpatient hospitalizations for ectopic pregnancy. Cohorts were identified by surgical treatment type-open procedure vs laparoscopic procedure. Race/ethnicity, primary payer status, and median household income were primary variables of interest. Univariate and multivariable analyses were conducted. SETTING: Nationwide inpatient analysis. PATIENTS: Women presenting for ectopic pregnancy treatment. INTERVENTIONS: Type of surgery. MEASUREMENTS AND MAIN RESULTS: Outcome measures were laparotomy vs laparoscopy for treatment. A total of 18 725 cases were identified, 8325 open and 10 400 laparoscopic. Hispanic women were more likely to receive open procedures as treatment for ectopic pregnancy than White women (odds ratio 1.226, p <.001). Women with private insurance were more likely to receive open procedures than women who used self-pay for treatment (odds ratio 0.809, p <.001). Women of lower median income status, <$60 000, were more likely to receive open procedures than women of the fourth quartile income group. Black women predominantly made up the first quartile income group. When controlling for covariates, Black women were not more likely to receive 1 method of surgical procedure over another. CONCLUSION: Income appears to be related to surgical management of ectopic pregnancy with women of lower median incomes receiving laparotomies over laparoscopic procedures. Equal access to healthcare remains a prudent need in communities of color. Further studies are needed to elucidate surgical decision-making in the management of ectopic pregnancy.