The Impact of Abortion Bans on Maternal and Reproductive Health in Virginia

Title: The Impact of Abortion Bans on Maternal and Reproductive Health in Virginia
Co-authors: Victoria Iveljic, Katie Volante, Eliza Liner, Holly Wilson, and Cityana Teshome
IRB Approved – Yes
Faculty Sponsor: Dr. Daniel Freedman – dfreedm@gmu.edu

Background: The overturn of Roe v. Wade returned the ability to regulate abortion to the states, no longer protecting the right to abortion at the federal level. Currently, 14 states have full bans on abortion (The New York Times, 2023). “It has been projected that a total ban on abortion would lead to a 21% increase in maternal mortality” (Kulczycki, 2022, as cited in Stevenson, 2021). Unsafe abortions present a slew of health risks including infection, hemorrhage, uterine perforation, internal organ damage, and mental distress (World Health Organization, 2021).

Purpose: The purpose of this study is to identify how the Dobbs v. Jackson Women’s Health Organization decision has impacted the medical care of individuals who can become pregnant in the state of Virginia.

Methods: This qualitative, phenomenological study primarily used snowball sampling to recruit participants. The target population was biologically female, English-speaking, Virginia residents who were 18 years or older who have been pregnant since the Dobbs decision. The researchers sampled from Planned Parenthood Centers, OB/GYN offices, and pre and postnatal support groups. Data was collected from semi-structured interviews and coded using thematic analysis. 10 respondents participated.

Results: Data has not yet been collected but will be completed by May 8, 2023.

Conclusions: This study has the potential to affect policy surrounding healthcare and reproductive rights. Based on themes generated after coding, individuals will have a detailed understanding of how recent legislation impacts the maternal and reproductive health outcomes of individuals in the U.S. who are able to become pregnant.

Welcome Everyone. My name is Katie Volante. My fellow group members are Victoria Iveljic, Eliza Liner, Holly Wilson, and Cityana Teshome and we’re here to present the research for our BSW capstone project which focuses on the impact of abortion bans on maternal and reproductive health in Virginia. For a little background on the issue, in 2022, the U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization denied abortion as a protected right under the U.S. Constitution, reversing the nearly 50 years of legal precedent set forth in Roe v. Wade and, ultimately, returned the ability to regulate abortion to the states. And while abortion remains accessible in Virginia, it’s important to note that it’s not explicitly protected by state or federal law. Though there is no universal consensus in the U.S., for the purpose of our study, viability is understood as occuring at approximately 24 weeks of gestational age, abortion is defined as the termination of pregnancy before the fetus has reached the stage of viability, and an unsafe abortion is one performed by an unqualified provider or in an unsanitary environment.

So why do we care about the impacts of abortion bans on maternal and reproductive healthcare in Virginia? Let’s begin with the research on the subject. Statistics have shown that 4.7-13.2% of maternal deaths are caused by unsafe abortions. This is an abortion that is completed outside of, you know, a hospital without a doctor that is qualified to do so. A total ban on abortion exacerbates issues already occurring in communities of color such as non-Hispanic Black individuals, projecting a 33% increase of maternal mortality and, overall, maternal mortality rates increase by 21%. We have included a graphic that depicts the states in America in which a total abortion ban is in place and the states in which a six-week ban is in effect. Georgia is the only state presented in this graphic, um, to have a six-week ban in effect and 14 states have a full ban in effect including Idaho, North and South Dakota, Wisconsin, Texas, Oklahoma, Montana, Arkansas, Louisiana, Mississippi, Kentucky, Tennessee, West Virginia, and Alabama. We can start to understand how the overturn of Roe v. Wade is beginning to effect fetus-carrying individuals.

There are a number of predicted outcomes for the Dobbs ruling including an increase in barriers to accessing time sensitive abortion care and even denial of such access in general. This can then lead to unsafe abortions which can lead to physical health problems such as infection, hemorrhage, incomplete abortions, uterine perforation, internal organ damage, and mental distress. Mental distress can come in the form of stress, anxiety, depression, and a number of other mental health symptoms that negatively impact those who are or can become pregnant. As previously mentioned, a total ban on abortions would increase the number of unsafe abortions leading to an overall rise in the percentage of maternal mortality rates. Data has shown that stricter abortion laws and decreases in abortion access, such as with the Dobbs ruling, leads to an increase in birth rates. However, this has shown to be temporary until people find a way to terminate their pregnancies, which are usually in the form of unsafe and self-managed abortions, leading to a rise in maternal mortality. Previous research has also shown that marginalized communities are disproportionately affected when it comes to access to abortion and healthcare, in general. The Dobbs ruling is predicted to only make this problem worse. Furthermore, the Dobbs ruling also puts anyone in the U.S. who is able to get pregnant in a vulnerable state for legal surveillance, civic detention, forced interventions, and criminal prosecution.

Alright! So our research question is in which ways do abortion bans implemented after Dobbs v. Jackson Women’s Health Organization impact the medical care of people who can get pregnant in Virginia? And now to talk a little bit about our study design. So our study design is a phenomenology which means we really want to capture the lived experiences of people. We’re going to be conducting snowball sampling in order to get participants. So initially we’re recruiting with flyers, um, and then whoever answers those and meets screening criteria will be counted in the participant pool and then, once we interview those participants, we’re going to ask them, um, if they have any people that they recommend – their friends or family – that they think might also be a good fit for this study and sample from them. As far as measurement goes, we’re going to do semi-structured interviews so we’re going to be holding interviews virtually over Zoom, just due to geographic constraints, and ask a series of open-ended questions to try and capture, um, themes and broad responses – allow the participants to give as much or as little detail as they want. And as far as data analysis goes, we’re going to transcribe those interviews and then code them using thematic analysis which like I said earlier, um, is just going through those transcriptions and pulling out key themes to see what responses and what recommendations, details, things like that, are most prevalent in our participant pool.

We took our sampling from Planned Parenthood Centers, the – from OB/GYN offices, from support groups for people who were dealing with issues related to our study, and from hospitals. Some limitations: Participants had to contact a researcher in order for them to participate. Another limitation we had was time. We did not have as much time as we would like – as we would have liked to have had – to complete our study. And also funding. We were limited by the fact that we did not have really any money to complete the study or to incentivize people or anything like that. Um. So some implications of our study: policy change and also, um, it will affect the delivery of services. If there’s any questions, feel free to ask!