The Dobbs v. Jackson Women’s Health Organization SCOTUS decision continues to have far-reaching implications for patients attempting to access quality abortion care. Three years after the Dobbs decision, despite the drastic and continued increase in abortion restrictions, the overall number of U.S. abortions continues to rise, superseding pre-Dobbs numbers. The demand for abortion services is clear and the care landscape has adapted to meet some of those demands. Although policy restrictions dictate access to and delivery of abortion care, attempts to document and quantify their overarching impacts on populations can risk overlooking the people and communities at the center. The criminalization of abortion and pregnancy heightens privacy concerns that make it harder to ethically and rigorously study abortion access, decision-making, and care—especially for equity-focused researchers working with marginalized populations.
Additionally, other often politicized health care services such as contraception, gender affirming care, and other family planning services have continued to experience political attacks under the second Trump administration. Examples of these attacks include but are not limited to: Medicaid funding cuts that target family planning, including the withholding of Title X funds; the Medina v. Planned Parenthood SCOTUS ruling which allows for states to exclude Planned Parenthood from Medicaid; and restrictions on gender affirming care access for minors resulting from the U.S. vs. Skrmetti SCOTUS decision. The restrictions on access to abortion care set in motion by the Dobbs decision have far reaching effects into other areas of reproductive health care, presenting challenges for reproductive health researchers at large, not just those working within the abortion space.
Given these developments, our panel at AcademyHealth’s 2025 Annual Research Meeting (ARM), entitled “Partnering with Community and Applying Evidence to Advance Reproductive Health,” with Dr. Tiffany Green, Nicole Quinones, Dr. Asha Hassan, Dr. Caitlin Russell, and Dr. Laura Lindberg, was timely and offered insights into cultivating meaningful partnerships that center communities as one solution to mitigate this research challenge. What unfolded in the session was a rich conversation about research, equity, and community partnership, which we recount below.
Research Needs Highlighted by the post-Dobbs Policy Landscape
Panelist and moderator Dr. Green kicked off the special session with a discussion of the importance of “person-centered abortion.” The Dobbs decision has innovatively changed the way medication abortion care is delivered with the use of telehealth and advanced provision medication abortion. In the midst of these changes, important considerations on the abortion preferences (e.g., “What aspects of abortion care matter most to members of Black communities?”) and resulting experiences of Black people and communities in particular have been overlooked. Dr. Green discussed some of the findings of her discrete choice experiment work, which found that patients choose abortion providers based on concerns about being judged for their choices and that one motivating factor to seek abortion care was health concerns if they were to carry the pregnancy to term. She also found that while medication abortion can be viewed as a ‘cure all’ for access and care delivery concerns in the current political environment, that some patients seeking abortion care did not want a medication abortion and that their preferences must be respected.
Presenter Nicole Quinones discussed the importance of broadening the way we think about the person-level impacts of Dobbs by partnering with communities and abortion providers. She encouraged us to think about the policy impacts Dobbs has on people’s lives beyond abortion. To shift our mindsets, Nicole noted that we must begin to view and understand that policy operates through systemic racism, racialization, and place-specific processes which influence the ways policies are felt differently among and between communities.
Partnering and Centering Marginalized Communities in Research
Drs. Hassan, Lindberg and Russell discussed the importance of partnering with abortion providers, adolescents, and military service members to advance reproductive health equity. Dr. Hassan called on researchers to respect clinical capacity and operational constraints when planning studies and to acknowledge that each clinic and affiliate is unique. The mission and values of each setting should also be taken into consideration when developing study design and research objectives. Dr. Lindberg discussed how adolescents are underrepresented in research and her efforts to bring them to the table by creating a community-engaged research panel. This initiative was successful due to its commitment to providing adolescents with training and using facilitated meetings to ensure adolescents were seen as equal collaborators. Dr. Russell spoke about the unique barriers to care that women serving in the military experience, as regulations often limit their ability to travel more than 250 miles from base without their leaderships’ explicit approval. She encouraged researchers to collaborate or consult with women who are currently or have previously served in the military when working with this population to incorporate the views of those with lived experience.
Three years after the Dobbs decision, there is still an ongoing need to study its impact at all levels. However, in trying to assess how the ever-evolving policies that govern abortion access impact health outcomes at the national level, we should never lose sight of how it impacts the individual. Every person seeking care comes with their own unique needs, preferences, and barriers to care. By partnering with patients and providers and taking the time to enmesh them in study design and research, we can develop collaborations that lead to rich data and high-impact interventions.
The opinions expressed in this blog post are the author's own and do not necessarily reflect the view of AcademyHealth or of their respective affiliated employers/organizations.