Senior Director, Epidemiology Syneos Health, United States
Background: With the Dobbs decision (Dobbs v. Jackson Women’s Health Organization ruling) on 24-Jun-2022, the US Supreme Court overturned Roe v. Wade (1973) and Planned Parenthood v. Casey (1992) and determined that the US Constitution did not protect the right to abortion. Abortion regulation returned to the state legislature where some states have increased restrictions or made it illegal. It is important to examine abortion trends before and after this ruling to understand potential impacts to social support and aid programs as well as public health, and surveillance efforts.
Objectives: To describe abortion trends before and after the Dobbs decision using electronic medical records (EMR) data within the TriNetX network, a live EMR database of >50M patients.
Methods: US female patients with any ICD-10, healthcare common procedure, diagnosis or medication code possibly associated with abortion or abortion-related services were identified. All related codes were analyzed into elective/induced abortion (IAB) or spontaneous abortion (SAB). For consistency among reporting periods, timing was categorized into two 6-month time periods: pre-Dobbs (between 25Jun2021-20Jan2022) and post-Dobbs (between 25Jun2022-20Jan2023).
Results: A total of 3,275,110 patients were identified that had any relevant code at any time within the total EMR population (644,830 in the pre-Dobbs time period and 630,930 post-Dobbs). The population had a mean age of 38.4 years, were majority white (58%) and not Hispanic or Latino (67%) (analysis 20-Jan-2023). Overall, the pre Dobbs period had 20,310 abortion events [2,710 (0.43%) IAB-specific and 17,600 (2.79%) SAB-specific] and the post-Dobbs period had 11,080 events [1,800 (0.28%) IAB-specific and 9,280 (1.44%) SAB-specific].
Conclusions: Data from the EMR database showed a marked decrease in codes associated with abortion events recorded in the 6-months after the Dobbs decision compared to the same 6-month period of the previous year before the ruling. Despite the known limitations of EMR data in completeness of abortion-related data, these results are consistent with national CDC induced abortion surveillance, which has reported continuous declines in abortion rates between 2011-2020. It is important to continue to monitor abortion trends, especially after the Dobbs decision while state legislature is in flux, to determine potential impacts on surveillance, studies that examine pregnancy outcomes, and plan for overall needs with regard to healthcare services, social support and aid programs.
