2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Objectives: In 2015, the Georgia (US) legislature implemented a
|
|
|
|
|
|
|
|
|
|
gestational limit, or ``ban{''''} on abortion at or beyond 22 weeks from
|
|
|
|
|
|
|
|
|
|
the last menstrual period. In this study, we qualitatively examined
|
|
|
|
|
|
|
|
|
|
abortion provider perspectives on the ban''s impact on abortion care
|
|
|
|
|
|
|
|
|
|
access and provision.Study design: Between May 2018 and September 2019,
|
|
|
|
|
|
|
|
|
|
we conducted in-depth individual interviews with 20 abortion providers
|
|
|
|
|
|
|
|
|
|
(clinicians, staff, and administrators) from four clinics in Georgia.
|
|
|
|
|
|
|
|
|
|
Interviews explored perceptions of and experiences with the ban and its
|
|
|
|
|
|
|
|
|
|
effects on abortion care. Team members coded tran-scripts to 100\%
|
|
|
|
|
|
|
|
|
|
agreement using an iterative, group consensus process, and conducted a
|
|
|
|
|
|
|
|
|
|
thematic analysis.Results: Participants reported strict adherence to the
|
|
|
|
|
|
|
|
|
|
ban and also its negative consequences: additional labor plus
|
|
|
|
|
|
|
|
|
|
service-delivery restrictions, legally constructed risks for providers,
|
|
|
|
|
|
|
|
|
|
intrusion into the provider-patient relationship, and impact of limited
|
|
|
|
|
|
|
|
|
|
services felt by patients and, thus, providers. Participants commonly
|
|
|
|
|
|
|
|
|
|
mentioned disparities in the ban''s impact and viewed the ban as
|
|
|
|
|
|
|
|
|
|
disproportionately affecting people of color, those experiencing
|
|
|
|
|
|
|
|
|
|
financial insecurity, and those with underlying medical conditions.
|
|
|
|
|
|
|
|
|
|
Nonetheless, participants described a clear, unrelenting commitment to
|
|
|
|
|
|
|
|
|
|
providing quality patient-centered care and dedication to and
|
|
|
|
|
|
|
|
|
|
satisfaction in their work. Conclusions: Georgia''s ban operates as
|
|
|
|
|
|
|
|
|
|
legislative interference, adversely affecting the provision of quality,
|
|
|
|
|
|
|
|
|
|
patient-centered abortion care, despite providers'' resilience and
|
|
|
|
|
|
|
|
|
|
commitment. These experiences in Georgia have timely and clear
|
|
|
|
|
|
|
|
|
|
implications for the entire country following the Supreme Court''s
|
|
|
|
|
|
|
|
|
|
decision to overturn Roe v Wade, thus reducing care access and
|
|
|
|
|
|
|
|
|
|
increasing negative health and social consequences and in-equities for
|
|
|
|
|
|
|
|
|
|
patients and communities on a national scale. Implications: Our findings
|
|
|
|
|
|
|
|
|
|
from Georgia (US) indicate an urgent need for coordinated efforts to
|
|
|
|
|
|
|
|
|
|
challenge the Dobbs v Jackson Women''s Health Organization decision and
|
|
|
|
|
|
|
|
|
|
for proactive policies that protect access to later abortion care.
|
|
|
|
|
|
|
|
|
|
Research that identifies strategies for supporting providers and
|
|
|
|
|
|
|
|
|
|
patients faced with continuing restrictive legal environments is
|
|
|
|
|
|
|
|
|
|
warranted.\& COPY; 2023 The Authors. Published by Elsevier Inc. This is
|
|
|
|
|
|
|
|
|
|
an open access article under the CC BY-NC-ND license
|
|
|
|
|
|
|
|
|
|
(http://creativecommons.org/licenses/by-nc-nd/4.0/).'
|
|
|
|
|
affiliation: 'Hartwig, SA (Corresponding Author), Ctr Reprod Hlth Res Southeast RISE,
|
|
|
|
|
Atlanta, GA 30322 USA.
|
|
|
|
|
|
|
|
|
|
Hartwig, SA (Corresponding Author), Emory Univ, Rollins Sch Publ Hlth, Atlanta,
|
|
|
|
|
GA 30322 USA.
|
|
|
|
|
|
|
|
|
|
Hartwig, Sophie A.; Youm, Awa; Contreras, Alyssa; Mosley, Elizabeth A.; McCloud,
|
|
|
|
|
Candace; Carroll, Erin; Lathrop, Eva; Cwiak, Carrie; Hall, Kelli Stidham, Ctr Reprod
|
|
|
|
|
Hlth Res Southeast RISE, Atlanta, GA 30322 USA.
|
|
|
|
|
|
|
|
|
|
Hartwig, Sophie A.; Youm, Awa; Contreras, Alyssa; Mosley, Elizabeth A.; McCloud,
|
|
|
|
|
Candace; Lathrop, Eva; Cwiak, Carrie; Hall, Kelli Stidham, Emory Univ, Rollins Sch
|
|
|
|
|
Publ Hlth, Atlanta, GA 30322 USA.
|
|
|
|
|
|
|
|
|
|
Goedken, Peggy; Lathrop, Eva; Cwiak, Carrie; Hall, Kelli Stidham, Emory Univ, Sch
|
|
|
|
|
Med, Dept Gynecol \& Obstet, Atlanta, GA USA.
|
|
|
|
|
|
|
|
|
|
Carroll, Erin, Univ Alabama Birmingham, Dept Hlth Care Org \& Policy, Birmingham,
|
|
|
|
|
AL USA.
|
|
|
|
|
|
|
|
|
|
Mosley, Elizabeth A., Univ Pittsburgh, Ctr Innovat Res Gender Hlth Equ CONVERGE,
|
|
|
|
|
Sch Med, Div Gen Internal Med, 230 McKee Pl, Pittsburgh, PA 15213 USA.
|
|
|
|
|
|
|
|
|
|
Lathrop, Eva, PSI, 1120 19th St,NW, Washington, DC 20036 USA.
|
|
|
|
|
|
|
|
|
|
Hall, Kelli Stidham, Columbia Univ, Mailman Sch Publ Hlth, 60 Haven Ave,B3 312,
|
|
|
|
|
New York, NY 10032 USA.'
|
|
|
|
|
article-number: '110059'
|
|
|
|
|
author: Hartwig, Sophie A. and Youm, Awa and Contreras, Alyssa and Mosley, Elizabeth
|
|
|
|
|
A. and McCloud, Candace and Goedken, Peggy and Carroll, Erin and Lathrop, Eva and
|
|
|
|
|
Cwiak, Carrie and Hall, Kelli Stidham
|
|
|
|
|
author-email: sophie.anne.hartwig@emory.edu
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Hartwig
|
|
|
|
|
given: Sophie A.
|
|
|
|
|
- family: Youm
|
|
|
|
|
given: Awa
|
|
|
|
|
- family: Contreras
|
|
|
|
|
given: Alyssa
|
|
|
|
|
- family: Mosley
|
|
|
|
|
given: Elizabeth A.
|
|
|
|
|
- family: McCloud
|
|
|
|
|
given: Candace
|
|
|
|
|
- family: Goedken
|
|
|
|
|
given: Peggy
|
|
|
|
|
- family: Carroll
|
|
|
|
|
given: Erin
|
|
|
|
|
- family: Lathrop
|
|
|
|
|
given: Eva
|
|
|
|
|
- family: Cwiak
|
|
|
|
|
given: Carrie
|
|
|
|
|
- family: Hall
|
|
|
|
|
given: Kelli Stidham
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1016/j.contraception.2023.110059
|
|
|
|
|
earlyaccessdate: JUL 2023
|
|
|
|
|
eissn: 1879-0518
|
|
|
|
|
files: []
|
|
|
|
|
issn: 0010-7824
|
|
|
|
|
journal: CONTRACEPTION
|
|
|
|
|
keywords: 'Abortion; Abortion clinic; Abortion policy; Health care delivery;
|
|
|
|
|
|
|
|
|
|
Qualitative research; United States'
|
|
|
|
|
keywords-plus: CONSTANT COMPARATIVE METHOD; HEALTH; WOMEN; LAW
|
|
|
|
|
language: English
|
|
|
|
|
month: AUG
|
|
|
|
|
number-of-cited-references: '31'
|
|
|
|
|
orcid-numbers: Hartwig, Sophie/0000-0003-3044-8220
|
|
|
|
|
papis_id: 6ef6bf23f2d1bcee48f175138e1d2ddc
|
|
|
|
|
ref: Hartwig2023rightthing
|
|
|
|
|
times-cited: '0'
|
|
|
|
|
title: '``The right thing to do would be to provide care ... and we can''t″: Provider
|
|
|
|
|
experiences with Georgia''s 22-week abortion ban ...'
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:001038762400001
|
|
|
|
|
usage-count-last-180-days: '0'
|
|
|
|
|
usage-count-since-2013: '0'
|
|
|
|
|
volume: '124'
|
|
|
|
|
web-of-science-categories: Obstetrics \& Gynecology
|
|
|
|
|
year: '2023'
|
