Sarah C. M. Roberts

Examines whether abortion-related complications differ between abortions provided in Ambulatory Surgery Centers (ASCs) and abortions provided in office-based settings. Finds no difference in complications between ASCs and office-based settings, including for second trimester and later abortions.

Examines the impact of state-level policies targeting alcohol use during pregnancy. Finds that, at best, state alcohol/pregnancy policies have no impact on adverse birth outcomes or prenatal care utilization, and, at worst, actually lead to increases in low birthweight and preterm birth and decreases in prenatal care utilization.

Examines women’s experiences with Utah’s 72-hour waiting period and two-visit requirement for abortion, which was the first 72-hour waiting period law to go into effect in the U.S. Overall, Utah’s 72-hour waiting period and two-visit requirement did not prevent women who presented for information visits from having abortions, but did burden women with financial costs, logistical hassles and extended periods of dwelling on decisions they had already made. They also led some women to worry that they may not be able to have the type of abortion they preferred and pushed at least one women beyond her facility’s gestational limit for providing abortion care. The two-visit requirement increased the cost of the abortion by 10% and the 72-hour wait was actually an 8-day wait in practice.

Using data from the UCSF Turnaway Study (n=956 women seeking abortion in the United States), we found that nearly 5% reported alcohol, tobacco, or drug use as a reason for deciding to have an abortion. Women reporting alcohol as a reason drank at levels exceeding a low threshold and did not appear to be terminating otherwise wanted pregnancies. None of the women reporting drug use as a reason reported fear of punishment as a reason for abortion. Ninety-eight percent of women reporting alcohol, tobacco, or drugs as a reason had unintended pregnancies. Findings are inconsistent with hypotheses that recommendations for abstinence from alcohol during pregnancy and punitive policies relating to drug use lead women using low levels of alcohol or using drugs to terminate otherwise wanted pregnancies.

Using qualitative data collected from pregnant and parenting women using alcohol and/or drugs in a California county, finds that women using drugs attended and avoided prenatal care for reasons not connected to their drug use: concern for the health of their baby, social support, and extrinsic barriers such as health insurance and transportation. Also finds that drug use itself was a barrier for a few women. In addition to drug use, women experienced multiple simultaneous risk factors. Both the drug use and the multiple simultaneous risk factors made resolving extrinsic barriers more difficult. Women also feared the effects of drug use on their baby's health and feared being reported to Child Protective Services, each of which influenced prenatal care use.