As the impacts of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health in 2022 ripple throughout the health care system, health services researchers represent a key component of the community working to document them and the impacts of policies enacted in response. Researchers at this year’s Annual Research Meeting (ARM) gathered during conference sessions daily to share findings and learn from one another’s challenges and successes doing this work.
We had the privilege of hosting a networking session on the final morning of ARM for people exploring the consequences of overturning Roe v. Wade, designed to inform how AcademyHealth supports this research, such as via its new Research Community on the Equity Impacts of Dobbs.
Reflections on Our Research and Motivations
In preparation for the session, we reflected on current challenges we face and motivations that keep us doing this work:
- Nicole Quinones, M.P.H.: My research focuses on the socioeconomic impacts of abortion access policy on people seeking abortions. A current challenge in this work is stigma and increased criminalization, both of which have increased since the Dobbs decision and have made conducting research more difficult. What motivates me to do this work is the momentum around abortion at this moment in history and knowing that these policies have real impacts on people's lives.
- Hao Yu, Ph.D.: My research focuses on the impacts of the Dobbs decision on the maternal care workforce. A common challenge for health workforce studies is the limited availability of health workforce data. By pulling information from multiple sources, my team has been able to identify adverse effects of state-level abortion bans implemented after Dobbs on the maternal care workforce. As these bans exacerbate the shortage and maldistribution of maternal care providers, the goal of my research is to contribute to the evidence base that can inform the development of effective policies to mitigate these adverse effects.
- Aakriti Shrestha, M.P.H.: My research focuses on understanding changes in reproductive health following the implementation of restrictive reproductive health policies. I am interested in understanding how reproductive health, including contraceptive use, has changed after the Dobbs decision. One current challenge I face in conducting this research is data collection, as individuals may be hesitant to share their contraceptive use. Despite the challenges, what motivates me to continue my work is not only a growing conversation about contraception in the wake of Dobbs, but the hope that identifying the changes in utilization will ultimately inform development of better reproductive health policies.
Research Needs, Challenges, and Opportunities for Studying the Impacts of Dobbs
In March, AcademyHealth published a report exploring the priorities, challenges, and legal landscape in which research related to the impacts of abortion bans is currently being conducted in the U.S. The publication includes a robust research agenda of research needs and discusses challenges facing researchers in addressing these questions, many of which ARM attendees highlighted, such as:
- Impacts of abortion exceptionalism on research funding
- Difficulty obtaining institutional support (e.g., IRBs) for approval and conduct of studies
- Data security and patient privacy
- Recruitment and data collection (e.g., online recruitment and bots)
- Legal concerns for patients, researchers, and providers
- Decreased access for medical students to abortion instruction/training
- Inequitable access to research information/evidence (e.g., community-based organizations lacking access to research publications)
Many challenges facing researchers today existed pre-Dobbs, such as data collection challenges, data limitations, and a need to recognize the stress affecting research partners who provide abortion care while building intentional community partnerships.
ARM attendees also identified opportunities for researchers to contribute to the evidence base, including:
- The potential of interdisciplinary research
- Working with organizations across the reproductive health advocacy space
- State policies that have led to increased Medicaid or private insurance coverage of abortion care
- Educating policymakers with evidence (e.g., about reproductive health care as prevention)
- Asking organizations working on the ground (clinics, community orgs, etc.) directly how researchers can support them
Innovations and Successes Are Cause for Hope
Despite the challenges acknowledged, we have also seen the innovations of this moment, like the #WeCount study and other creative approaches to conducting research in the face of adversity. ARM session participants elevated successes and innovative solutions they have seen in research and health care in response to the Dobbs decision, such as:
- The impact of abortion funds, especially at local levels in restrictive environments
- Role of telehealth
- Interdisciplinary work
- Novel research methods and approaches
- Use of new and emerging technologies to support research (AI, machine learning)
- Practical and clinical information support offered by hotlines
Strengthening Partnerships and Community for Research on the Impacts of Dobbs
ARM attendees shared suggestions for what AcademyHealth could do to support researchers studying the consequences of Dobbs, including continuing to host sessions at ARM about the evolving nature of reproductive health research; coordinating across the research community to minimize duplication of efforts; and facilitating mentorship and collaboration opportunities, especially for and among early-career researchers.
For health services researchers interested in continuing the conversation, sharing effective research practices and approaches, or getting involved in this work for the first time, AcademyHealth is launching a new Research Community on the Equity Impacts of Dobbs. In partnership with the Society of Family Planning and the Commonwealth Fund, this community will examine the health equity impacts and broader effects of the Dobbs decision on the health care system via bimonthly convenings and webinars.
Research Community details are available here, as well as information about two leadership opportunities: Reproductive Health Senior Scholars in Residence and Advisory Council members (applications due September 17).
As emphasized by ARM session participants, we also endeavor to keep front and center in these research efforts those who are most marginalized to advance health equity and bring to life the goals of reproductive justice: the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.