Measuring abortion in restrictive settings: applying global lessons to the United States after the fall of Roe

As a result of the United States Supreme Court’s June 2022 decision in Dobbs v. Jackson Women’s Health Organization, the landscape of reproductive health care in the US is in the midst of seismic and rapid change. Abrupt changes in access to abortion in the US are without precedent in terms of the number of individuals who are affected, the number of states in which there remains substantial uncertainty around abortion policy changes in the near future, and the scale of potential effects on the lives of pregnant people. This presentation will discuss a new project underway to assess the impact of state abortion restrictions on the health of pregnant people, as well as the need for high quality estimates of abortion incidence both within and outside of the formal health care system as these restrictions are implemented. This includes the newly launched Monthly Abortion Provision Study and, drawing from lessons learned measuring abortion in restrictive settings globally, an adaptation of the Abortion Incidence Complications Method. This new work is aimed at establishing estimation approaches that encompass both facility-based and self-managed procedures and are designed for a context in which the legal status of abortion is hybridized and subject to rapid, ongoing changes, laying the foundation for a new surveillance infrastructure that will be needed for the foreseeable future in the US.

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