Who receives abortions at 6- or 16-weeks' gestation? A case study from Ohio

In the United States, states enacted gestation-based bans following the US Supreme Court case Dobbs v. Jackson Women's Health Organization. We examined how patient characteristics differed by gestation at abortion. We used data from a 20% random sample of charts at three Ohio abortion facilities for patients who visited 2014-2018. We used logistic regression to calculate unadjusted and adjusted odds of abortion before 6 weeks and at 16 weeks or after, based on sociodemographic characteristics. We analysed 4,926 charts. Black patients and those of another race had lower odds of abortion before 6 weeks compared to White patients (odds ratio [OR]: 0.30, CI: 0.21-0.42, p < 0.001; and OR: 0.64, CI: 0.41-0.995, p = 0.048, respectively), as did those from out-of-state (OR: 0.22, CI: 0.11-0. 42, p < 0.001). Patients aged 30 and older (compared to those under 25; OR: 1.66, CI: 1.25-2.21, p < 0.001), those with a college degree (OR: 2.60, CI: 2.03-3.33, p < 0.001), married patients (OR: 1.77, CI: 1.27-2.46, p < 0.001), and those without children (OR: 1.29, CI: 1.01-1.66, p = 0.041) had higher odds. Patients with a college degree and those without children had lower odds of abortion at 16 weeks or after (OR: 0.67, CI: 0.49-0.91, p = 0.010; and OR: 0.75, CI: 0.58-0.97, p = 0.030, respectively), while those from out-of-state had higher odds (OR: 2.18, CI: 1.64-2.90, p < 0.001). Laws restricting access to abortion create inequitable harms to pregnant people, with particular impacts on patients of colour, those with less education, younger patients, and parents. As states restrict abortion, accessing timely care may become particularly challenging for those experiencing systemic discrimination.