IMPACTS OF RESTRICTIVE ABORTION LEGISLATION ON PREGNANCY OUTCOMES AT A SAFETY NET HOSPITAL IN ATLANTA, GEORGIA Public
Marcovitch, Hannah (Spring 2024)
Published
Abstract
Introduction:
Following the Dobbs decision in 2022, Georgia’s House Bill 481 (HB481), a ban limiting abortion after approximately 6 weeks, went into effect. To date, no study has explored the law’s impacts on key clinical indicators of maternal morbidity and mortality.
Objective:
The purpose of this study was to examine whether enactment of HB481 has been associated with changes pregnancy-related morbidity at a safety net hospital in Atlanta, Georgia to better characterize risks to pregnancy after the law went into effect.
Methods:
We conducted a population-based study of all pregnancies with documented deliveries or miscarriages managed at Grady Memorial Hospital between July 2021 and July 2023. The primary outcomes of interest in this study were miscarriage diagnosis, early pregnancy complication (between 6 and 22 weeks EGA), and pregnancy complication throughout gestation during this period. Trends in each of these outcomes were evaluated over the course of the study period using an interrupted time series retrospective study design with Poisson regression. Secondary outcomes of interest for this study included cause-specific miscarriage diagnoses, cause-specific maternal morbidity, perinatal outcomes, and CDC-defined severe maternal morbidity (SMM).
Results:
A total of 3,754 unique pregnancies were included in the study. In the 24,326 pregnancy-months of data, 7,614 occurred in the six months after enactment and 16,712 in the year before. The rate of miscarriage diagnosis (RR 1.10, 95% CI 0.77, 1.56) and pregnancy complication at any gestational age (RR 1.05, 95% CI 0.98, 1.12) did not change after vs. before HB481 went into effect. The rate of early pregnancy complication (RR 1.28, 95% CI 0.86, 1.91) demonstrated trend toward increasing after vs. before that may have clinical relevance.
Conclusions:
Given the already unacceptably high rates of maternal morbidity in Georgia and existing challenges in access to pregnancy care in the state; HB481 is a further threat to healthy pregnancy and sits in direct opposition to Georgians’ reproductive justice. It remains essential that researchers document the health impacts of this legislation as it remains in effect, with particular attention to populations most at risk of harm. Further, with laws similar to HB481 in effect in states across the United States, studies with similar objectives to this one must continue to document the direct health impacts of restrictive abortion policy on pregnancy outcomes nationwide.
Table of Contents
a. Distribution Agreement
b. Approval Sheet
c. Abstract Cover Page
d. Abstract
e. Cover Page
f. Full Thesis
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IMPACTS OF RESTRICTIVE ABORTION LEGISLATION ON PREGNANCY OUTCOMES AT A SAFETY NET HOSPITAL IN ATLANTA, GEORGIA () | 2024-04-25 14:38:41 -0400 |
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