Abortion volume in western Pennsylvania before and after the Dobbs v. Jackson decision

We examined changes in abortion numbers and characteristics between two different practice settings in western Pennsylvania (PA) before and after the Dobbs v. Jackson Women's Health Organization Supreme Court decision.

We conducted a retrospective cohort study of abortions performed at an academic medical center (in-hospital) and a freestanding abortion clinic (out-of-hospital) between July 1, 2021 and May 31, 2023. We collected data on total number of abortions, gestational duration (GD), proportion performed in the second trimester, type of abortion, and patient age and state of residence. We compared abortions between July 1, 2021 and May 31, 2022 (pre-Dobbs) to those between July 1, 2022 and May 31, 2023 (post-Dobbs) using t tests, Mann-Whitney U tests, and Chi-square tests. We repeated the analysis stratifying by practice setting.

The total number of abortions across the two sites was 3114 pre-Dobbs and 3153 post-Dobbs. Post-Dobbs in-hospital abortions had a lower median GD than pre-Dobbs (9 vs. 12 weeks, p < 0.01) and were less likely to be from out-of-state (41/467 (8.8%) vs. 59/450 (13.1%), p = 0.04). In contrast, post-Dobbs out-of-hospital abortions had a higher median GD than pre-Dobbs (9 vs. 8 weeks, p < 0.01) and were more likely to be from out-of-state (714/2686 (26.6%) vs. 434/2664 (16.3%), p < 0.01).

Out-of-hospital abortions were more likely to be from out-of-state and occurred at later gestational durations post-Dobbs compared with pre-Dobbs, while the opposite trends were seen for in-hospital abortions. The differences between sites suggest that the burden of increased demand from out-of-state patients was disproportionately absorbed by community abortion providers.