Characteristics of Patients Undergoing Fetal Potassium Chloride Injection at a Single Center Over Time

Area of Science:

• Medical Science
• Public Health
• Reproductive Health

Background:

• The 2022 Dobbs decision significantly altered abortion access across the U.S.
• Fetal potassium chloride (KCl) injections are a method for second- and third-trimester abortions.
• Understanding patient demographics and access patterns is crucial in the evolving legal landscape.

Purpose of the Study:

• To describe patient characteristics receiving fetal KCl injections in Colorado, a state with protective laws.
• To compare patient data and procedural trends before and after the Dobbs decision.
• To analyze changes in patient travel distance and area deprivation index (ADI) in response to legal changes.

Main Methods:

• Descriptive study analyzing patient records from January 2014 to December 2023.
• Inclusion of 119 patients undergoing fetal KCl injections.
• Analysis of demographic data, parity, procedure details, distance traveled, and ADI, with pre- and post-Dobbs comparisons using Chi-squared and Mann-Whitney U tests.

Main Results:

• A 6.4-fold increase in procedure volume was observed post-Dobbs (56 pre-Dobbs vs. 63 post-Dobbs).
• Median patient travel distance significantly increased from 29.8 to 383.9 miles post-Dobbs (p=0.004).
• Patient characteristics and gestational duration remained largely unchanged, while singleton procedures increased post-Dobbs.

Conclusions:

• Fetal KCl injection procedures increased significantly after the Dobbs decision, even within states maintaining protective abortion laws.
• Increased travel distances for patients underscore challenges in accessing care post-Dobbs.
• The findings highlight a growing demand for these procedures and the need for continued access to reproductive healthcare services.