ObjectiveTo determine which characteristics and circumstances were associated with very early and second-trimester abortion.MethodsPaper and pencil surveys were collected from a national sample of 8,380 non-hospital U.S. abortion patients in 2014 and 2015. We used self-reported LMP to calculate weeks gestation; when LMP was not provided we used self-reported weeks pregnant. We constructed two dependent variables: obtaining a very early abortion, defined as six weeks gestation or earlier, and obtaining second-trimester abortion, defined as occurring at 13 weeks gestation or later. We examined associations between the two measures of gestation and a range of characteristics and circumstances, including type of abortion waiting period in the patients’ state of residence.ResultsAmong first-trimester abortion patients, characteristics that decreased the likelihood of obtaining a very early abortion include being under the age of 20, relying on financial assistance to pay for the procedure, recent exposure to two or more disruptive events and living in a state that requires in-person counseling 24–72 hours prior to the procedure. Having a college degree and early recognition of pregnancy increased the likelihood of obtaining a very early abortion. Characteristics that increased the likelihood of obtaining a second-trimester abortion include being Black, having less than a high school degree, relying on financial assistance to pay for the procedure, living 25 or more miles from the facility and late recognition of pregnancy.ConclusionsWhile the availability of financial assistance may allow women to obtain abortions they would otherwise be unable to have, it may also result in delays in accessing care. If poor women had health insurance that covered abortion services, these delays could be alleviated. Since the study period, four additional states have started requiring that women obtain in-person counseling prior to obtaining an abortion, and the increase in these laws could slow down the trend in very early abortion.

The IPUMS Contextual Determinants of Health (CDOH) data series includes measures of disparities, policies, and counts, by state or county, for historically marginalized populations in the United States including Black, Asian, Hispanic/Latina/o/e/x, and LGBTQ+ persons, and women. The IPUMS CDOH data are made available through ICPSR/DSDR for merging with the National Couples' Health and Time Study (NCHAT), United States, 2020-2021 (ICPSR 38417) by approved restricted data researchers. All other researchers can access the IPUMS CDOH data via the IPUMS CDOH website. Unlike other IPUMS products, the CDOH data are organized into multiple categories related to Race and Ethnicity, Sexual and Gender Minority, Gender, and Politics. The CDOH measures were created from a wide variety of data sources (e.g., IPUMS NHGIS, the Census Bureau, the Bureau of Labor Statistics, the Movement Advancement Project, and Myers Abortion Facility Database). Measures are currently available for states or counties from approximately 2015 to 2020. The Gender measures in this release include state-level abortion access, which reports the proportion of a state's females aged 15-44 who reside in counties with an abortion provider by year and month from 2009-2022. To work with the IPUMS CDOH data, researchers will need to first merge the NCHAT data to DS1 (MATCH ID and State FIPS Data). This merged file can then be linked to the IPUMS CDOH datafile (DS2) using the STATEFIPS variable.

BackgroundIn February 2011, an Ohio law took effect mandating use of the United States Food and Drug Administration (FDA)-approved protocol for mifepristone, which is used with misoprostol for medication abortion. Other state legislatures have passed or enacted similar laws requiring use of the FDA-approved protocol for medication abortion. The objective of this study is to examine the association of this legal change with medication abortion outcomes and utilization.Methods and FindingsWe used a retrospective cohort design, comparing outcomes of medication abortion patients in the prelaw period to those in the postlaw period. Sociodemographic and clinical chart data were abstracted from all medication abortion patients from 1 y prior to the law’s implementation (January 2010–January 2011) to 3 y post implementation (February 2011–October 2014) at four abortion-providing health care facilities in Ohio. Outcome data were analyzed for all women undergoing abortion at ≤49 d gestation during the study period. The main outcomes were as follows: need for additional intervention following medication abortion (such as aspiration, repeat misoprostol, and blood transfusion), frequency of continuing pregnancy, reports of side effects, and the proportion of abortions that were medication abortions (versus other abortion procedures). Among the 2,783 medication abortions ≤49 d gestation, 4.9% (95% CI: 3.7%–6.2%) in the prelaw and 14.3% (95% CI: 12.6%–16.0%) in the postlaw period required one or more additional interventions. Women obtaining a medication abortion in the postlaw period had three times the odds of requiring an additional intervention as women in the prelaw period (adjusted odds ratio [AOR] = 3.11, 95% CI: 2.27–4.27). In a mixed effects multivariable model that uses facility-months as the unit of analysis to account for lack of independence by site, we found that the law change was associated with a 9.4% (95% CI: 4.0%–18.4%) absolute increase in the rate of requiring an additional intervention. The most common subsequent intervention in both periods was an additional misoprostol dose and was most commonly administered to treat incomplete abortion. The percentage of women requiring two or more follow-up visits increased from 4.2% (95% CI: 3.0%–5.3%) in the prelaw period to 6.2% (95% CI: 5.5%–8.0%) in the postlaw period (p = 0.003). Continuing pregnancy was rare (0.3%). Overall, 12.6% of women reported at least one side effect during their medication abortion: 8.4% (95% CI: 6.8%–10.0%) in the prelaw period and 15.6% (95% CI: 13.8%–17.3%) in the postlaw period (p < 0.001). Medication abortions fell from 22% (95% CI: 20.8%–22.3%) of all abortions the year before the law went into effect (2010) to 5% (95% CI: 4.8%–5.6%) 3 y after (2014) (p < 0.001). The average patient charge increased from US$426 in 2010 to US$551 in 2014, representing a 16% increase after adjusting for inflation in medical prices. The primary limitation to the study is that it was a pre/post-observational study with no control group that was not exposed to the law.ConclusionsOhio law required use of a medication abortion protocol that is associated with a greater need for additional intervention, more visits, more side effects, and higher costs for women relative to the evidence-based protocol. There is no evidence that the change in law led to improved abortion outcomes. Indeed, our findings suggest the opposite. In March 2016, the FDA-protocol was updated, so Ohio providers may now legally provide current evidence-based protocols. However, this law is still in place and bans physicians from using mifepristone based on any new developments in clinical research as best practices continue to be updated.

The IPUMS Contextual Determinants of Health (CDOH) data series includes measures of disparities, policies, and counts, by state or county, for historically marginalized populations in the United States including Black, Asian, Hispanic/Latina/o/e/x, and LGBTQ+ persons, and women. The IPUMS CDOH data are made available through ICPSR/DSDR for merging with the National Couples' Health and Time Study (NCHAT), United States, 2020-2021 (ICPSR 38417) by approved restricted data researchers. All other researchers can access the IPUMS CDOH data via the IPUMS CDOH website. Unlike other IPUMS products, the CDOH data are organized into multiple categories related to Race and Ethnicity, Sexual and Gender Minority, Gender, and Politics. The CDOH measures were created from a wide variety of data sources (e.g., IPUMS NHGIS, the Census Bureau, the Bureau of Labor Statistics, the Movement Advancement Project, and Myers Abortion Facility Database). Measures are currently available for states or counties from approximately 2015 to 2020. The Gender measures in this release include the state-level poverty ratio, which compares the proportion of females living in poverty to the proportion of males living in poverty in a given state in a given year. To work with the IPUMS CDOH data, researchers will need to first merge the NCHAT data to DS1 (MATCH ID and State FIPS Data). This merged file can then be linked to the IPUMS CDOH datafile (DS2) using the STATEFIPS variable.

Administrative claims and electronic health records are valuable resources for evaluating pharmaceutical effects during pregnancy. However, direct measures of gestational age are generally not available. Establishing a reliable approach to infer the duration and outcome of a pregnancy could improve pharmacovigilance activities. We developed and applied an algorithm to define pregnancy episodes in four observational databases: three US-based claims databases: Truven MarketScan® Commercial Claims and Encounters (CCAE), Truven MarketScan® Multi-state Medicaid (MDCD), and the Optum ClinFormatics® (Optum) database and one non-US database, the United Kingdom (UK) based Clinical Practice Research Datalink (CPRD). Pregnancy outcomes were classified as live births, stillbirths, abortions and ectopic pregnancies. Start dates were estimated using a derived hierarchy of available pregnancy markers, including records such as last menstrual period and nuchal ultrasound dates. Validation included clinical adjudication of 700 electronic Optum and CPRD pregnancy episode profiles to assess the operating characteristics of the algorithm, and a comparison of the algorithm’s Optum pregnancy start estimates to starts based on dates of assisted conception procedures. Distributions of pregnancy outcome types were similar across all four data sources and pregnancy episode lengths found were as expected for all outcomes, excepting term lengths in episodes that used amenorrhea and urine pregnancy tests for start estimation. Validation survey results found highest agreement between reviewer chosen and algorithm operating characteristics for questions assessing pregnancy status and accuracy of outcome category with 99–100% agreement for Optum and CPRD. Outcome date agreement within seven days in either direction ranged from 95–100%, while start date agreement within seven days in either direction ranged from 90–97%. In Optum validation sensitivity analysis, a total of 73% of algorithm estimated starts for live births were in agreement with fertility procedure estimated starts within two weeks in either direction; ectopic pregnancy 77%, stillbirth 47%, and abortion 36%. An algorithm to infer live birth and ectopic pregnancy episodes and outcomes can be applied to multiple observational databases with acceptable accuracy for further epidemiologic research. Less accuracy was found for start date estimations in stillbirth and abortion outcomes in our sensitivity analysis, which may be expected given the nature of the outcomes.

Project Summary: The purpose of this study was to inform experimental testing of new approaches for measuring abortion in surveys in the United States, by improving our understanding of how women interpret and respond to survey items asking them to report their abortion history. Using cognitive interviews, we developed, tested, and evaluated various question wordings, as well as conducted card sort and vignette activities to further discern how participants’ understand and classify abortion. We aimed to test questions to clarify which experiences to report as an abortion; reduce the stigma and sensitivity of abortion; reduce the sense of intrusiveness of asking about abortion; or increase the motivation to report. Question wordings were newly developed or modified versions of existing survey questions. Results from the cognitive interviews were used to develop an experimental survey to further explore how to improve the accuracy of abortion reporting. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health under Award Number R01HD084473. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Data Overview: We conducted cognitive interviews with 64 cisgender women in suburban Wisconsin (N=35) in January 2020 and urban New Jersey (N=29) in February 2020. We selected the two study states because of differences in abortion climate and to avoid geographically-specific findings. Participants were recruited to participate in an interview on sexual and reproductive health (SRH) by a third-party recruiting agency. Eligible participants were between the ages of 18 and 49, assigned female at birth, identified as women, spoke English, lived in Wisconsin or New Jersey, and had ever had penile-vaginal sex. Additionally, respondents were asked if they ever had an abortion during the screening process. The decision to include women with various abortion histories was deliberate. We sought to include respondents who may not have disclosed their abortion during the screening process and wanted feedback from all women of reproductive age, as that is the target sample of the experimental survey. We included feedback from both groups of respondents and highlighted their differences when applicable. The study was reviewed and approved by the Guttmacher Institute’s Institutional Review Board. Interviews lasted about 60-90 minutes and were conducted in private rooms at conference and market research locations by two members of the research team (AV and JM; see Interviewer Identities document). Interviews were audio recorded. We obtained verbal consent from all study participants, and they completed a short sociodemographic questionnaire at the end of the interview. Participants received $150 cash as a token of appreciation for their time. Sixteen respondents demonstrated accurate understanding of data sharing and consented to having their data be publicly shared; therefore, these are the only transcripts made available here. Data Collection Overview: The cognitive interview included several sections. In the first section, we asked participants to respond to and provide feedback on various versions of questions about their abortion history. In this section, they disclosed their abortion history directly to the interviewer. In the second section, we asked participants to provide feedback on several different introductory text options that might come before a question about their abortion history. In the third section, we asked participants more general questions about how they would prefer to be asked about whether they’d had an abortion on a survey, as well as their definition of abortion and why some people may choose not to disclose their abortion history. In sections 4 and 5, we conducted a card sort activity and went through a series of vignettes to further discern participants’ understanding and classification of abortion. Each interview was digitally audio recorded (.mp3). The audio recordings were uploaded from the devices to a folder on the Guttmacher network. The audio recordings will be uploaded to the secure, password-protected servers of the professional transcription agency, Datalyst LLC., for transcription. The audio recordings were deleted from the Datalyst servers upon completion of transcription and certification by Guttmacher staff that transcription was accurate/complete. Transcripts were cleaned by one of two team members; during this process, they also removed any potentially identifying information. Audio recordings were deleted from the devices at the end of data collection. The interviewer electronically wrote up immediate thoughts and impressions post-interview in memos (.docx) using a predetermined memo shell that mirrored the major sections of the interview guide. At the end...

The 1996 Uzbekistan Demographic and Health Survey (UDHS) is a nationally representative survey of 4,415 women age 15-49. Fieldwork was conducted from June to October 1996. The UDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Institute of Obstetrics and Gynecology implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The 1996 UDHS was the first national-level population and health survey in Uzbekistan. It was implemented by the Research Institute of Obstetrics and Gynecology of the Ministry of Health of Uzbekistan. The 1996 UDHS was funded by the United States Agency for International development (USAID) and technical assistance was provided by Macro International Inc. (Calverton, Maryland USA) through its contract with USAID. OBJECTIVES AND ORGANIZATION OF THE SURVEY The purpose of the 1996 Uzbekistan Demographic and Health Survey (UDHS) was to provide an information base to the Ministry of Health for the planning of policies and programs regarding the health of women and their children. The UDHS collected data on women's reproductive histories, knowledge and use of contraception, breastfeeding practices, and the nutrition, vaccination coverage, and episodes of illness among children under the age of three. The survey also included, for all women of reproductive age and for children under the age of three, the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutritional status. A secondary objective of the survey was to enhance the capabilities of institutions in Uzbekistan to collect, process and analyze population and health data so as to facilitate the implementation of future surveys of this type. MAIN RESULTS Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of Uzbekistan of 3.3 children per woman. Fertility levels differ for different population groups. The TFR for women living in urbml areas (2.7 children per woman) is substantially lower than for women living in rural areas (3.7). The TFR for Uzbeki women (3.5 children per woman) is higher than for women of other ethnicities (2.5). Among the regions of Uzbekistan, the TFR is lowest in Tashkent City (2.3 children per woman). Family Planning. Knowledge. Knowledge of contraceptive methods is high among women in Uzbekistan. Knowledge of at least one method is 89 percent. High levels of knowledge are the norm for women of all ages, all regions of the country, all educational levels, and all ethnicities. However, knowledge of sterilization was low; only 27 percent of women reported knowing of this method. Fertility Preferences. A majority of women in Uzbekistan (51 percent) indicated that they desire no more children. Among women age 30 and above, the proportion that want no more children increases to 75 percent. Thus, many women come to the preference to stop childbearing at relatively young ages when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization, However, there is a deficiency of both knowledge and use of this method in Uzbekistan. In the interest of providing couples with a broad choice of safe and effective methods, information about this method and access to it should be made available so that informed choices about its suitability can be made by individual women and couples. Induced Aboration : Abortion Rates. From the UDHS data, the total abortion rate (TAR)the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rateswas calculated. For Uzbekistan, the TAR for the period from mid-1993 to mid-1996 is 0.7 abortions per woman. As expected, the TAR for Uzbekistan is substantially lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakstan (1.8), Romania (3.4 abortions per woman), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively). Infant mortality : In the UDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid- 1992 to mid- 1996), infant mortality in Uzbekistan is estimated at 49 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 23 and 26 per 1,000. Maternal and child health : Uzbekistan has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women's consulting centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout rural areas. Nutrition : Breastfeeding. Breastfeeding is almost universal in Uzbekistan; 96 percent of children born in the three years preceding the survey are breastfed. Overall, 19 percent of children are breastfed within an hour of delivery and 40 percent within 24 hours of delivery. The median duration of breastfeeding is lengthy (17 months). However, durations of exclusive breastfeeding, as recommended by WHO, are short (0.4 months). Prevalence of anemia : Testing of women and children for anemia was one of the major efforts of the 1996 UDHS. Anemia has been considered a major public health problem in Uzbekistan for decades. Nevertheless, this was the first anemia study in Uzbekistan done on a national basis. The study involved hemoglobin (Hb) testing for anemia using the Hemocue system. Women. Sixty percent of the women in Uzbekistan suffer from some degree of anemia. The great majority of these women have either mild (45 percent) or moderate anemia (14 percent). One percent have severe anemia.

This dataset includes all valid felony, misdemeanor, and violation crimes reported to the New York City Police Department (NYPD) for all complete quarters so far this year (2017). For additional details, please see the attached data dictionary in the ‘About’ section.

The study examined to the extent to which the parents of unmarried teenagers under 18 are informed that their daughters are attending a family planning clinic or abortion facility,how parents have been informed, and how notification requirements would effect the behavior of those teenagers whose parents do not know. The data are based on an Alan Guttmacher Institute survey of 1,241 young women seeking contraceptive services from 53 family planning clinics and another 1,170 seeking abortion services. The present data set contains data only for the teenagers seeking contraceptive services. Data were collected during the period of October, 1979 to March, 1980. Each respondent was asked whether or not her parents knew about her clinic visit for contraceptive services and, if her parents did not know, what ahe would have done (with respect to contraceptive and aexual behavior, and utilization of clinic services) if their notification had been required by the clinic. The study was also designed to determine what proportion of teenagers whose parents knew they were getting birth control services had told them voluntarily, what propor tion had told them because the clinic required them to do so, and whether or not the teenager talked about ways of preventing pregnancy with their parents. The survey asked each respondent if she had ever used the pill, IUD, or diaphragm and what birth control method she intended to obtain from the clinic. The 30 respondents who chose nonprescription methods are not included in this dataset. Finally, the women were asked with whom they lived: teenagers who did not answer that they were living with their husbands were assumed to be unmarried.

IntroductionPrior research found that suicidality increased among commercially insured birthing people between 2006 and 2017. The 2022 Dobbs v. Jackson Women's Health Organization decision overturned Roe v. Wade and made obtaining an abortion more difficult across the United States, which may have negative mental health effects among commercially insured birthing people.MethodsWe conducted a cross-sectional analysis using mixed-effects logistic regression models to quantify the relationship between state-level abortion restrictions and a diagnosis of suicidality or self-harm in the 12 months before or after delivery among individuals with employer-sponsored health insurance in the United States who delivered between 2010 and 2020.ResultsOf the 610,177 deliveries in our final analytic cohort, birthing people residing in states with high abortion restrictiveness were younger (12.8% of birthing people were ages 15–24 compared to 7.8% in low restriction states) and more likely to be Black (10.4% compared to 6.1%). Birthing people living in states with high abortion restrictiveness were more likely to experience suicidality than birthing people living in states with low abortion restrictiveness [odds ratio (OR): 1.5; 95% CI: 1.2, 1.8; p = 0.0012]. When controlling for age, state abortion restrictiveness was not significantly associated with suicidality [adjusted odds ratio (adjOR): 1.2; 95% CI: 1.0, 1.4; p = 0.0603], and birthing people ages 15–24 were substantially more likely than birthing people ages 35–44 to experience suicidality (adjOR: 7.3; 95% CI: 6.5, 8.2; p 

Source: UNFPAUnit costs (2012 US dollars) of contraceptive methods per year.