Since the 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health overturned the constitutional right to abortion and left the question of reproductive rights in the hands of state governments, the consequences for access to care, (including and beyond reproductive health services), pregnancy health, clinician workforce, and broader health care delivery have been wide-ranging. Nearly 1 in 3 women of reproductive age—an estimated 21.5 million people—live in states that now either totally ban abortion or restrict access after six weeks.
As some states have moved to bolster access and strengthen legal protections for providers, others have instead enacted compounding restrictions that disproportionately affect people who already face significant health disparities due to poverty and structural racism, especially those individuals with multiple, intersecting, historically marginalized identities.
Health services research (HSR) can play an important role in examining the implications of the Dobbs decision both throughout the health care system and more broadly. In November 2023, AcademyHealth convened a workshop of the reproductive health and health services research communities, co-hosted by The Commonwealth Fund. These 80 participants discussed the legal context and background of access to abortion; the broad and sometimes unintended consequences of Dobbs; the role of state policy in access to reproductive and other health care for pregnant people and those of reproductive age; and research design considerations.
A new brief summarizes that discussion and includes an appendix describing considerations for conducting such research with an equity lens and identifying priority research questions across six domains:
- Access, availability, and safety of abortion services.
- Other reproductive health care, including maternal and perinatal care and outcomes.
- Non-reproductive health care and outcomes, including mental and behavioral health, disability, and chronic disease.
- Health care workforce implications, including training impacts, reproductive health deserts, and clinician burnout.
- Care financing and delivery issues, including Medicaid, safety-net providers such as federally qualified health centers, and data privacy.
- Broader societal impacts, including employment, education, and poverty.
Participants emphasized the importance of meaningful leadership and engagement of community members and organizations in any research examining the impact of Dobbs.
On March 6, join us for a webinar during which speakers with expertise in reproductive health services research and policy will share their key takeaways from the November discussion, including the critical need for partnerships between the HSR and reproductive health research communities.