Faculty of 1000 evaluation for The public health threat of anti-abortion legislation [dataset]

Carole Joffe
2014 F1000 - Post-publication peer review of the biomedical literature   unpublished
What happens when abortion access is severely restricted for 26 million Americans? Texas is about to find out. In July 2013, the Texas legislature passed one of the country's most restrictive laws that not only bans most abortions after 22 weeks and limits the use of medical abortion but also contains several provisions that are likely to lead to the closure of most abortion clinics in the state. The law requires facilities to meet the standards of ambulatory surgery centers (ASCs) and mandates
more » ... physicians to have admitting privileges at nearby hospitals. Proponents of the law claim it will improve safety, despite overwhelming evidence that abortions provided in outpatient clinics have a very low level of complications [1] . This legislation comes on the heels of measures passed in 2011 that drastically reduced funding for family planning, effectively removed Planned Parenthood from all state-funded family planning programs and required women seeking abortion to make an extra visit at least 24 hours before the abortion in order to undergo an ultrasound and listen to a detailed description of its images. Texas is only one of several states attempting to regulate abortion out of existence -a trend that should be deeply troubling to the medical community. First, it represents a stunning incursion into the physician's exam room, allowing state representatives to dictate how doctors should practice medicine. Second, it is in blatant contradiction to evidence-based medicine. One of the provisions of the Texas law requires doctors to follow the regimen for medical abortion included in the mifepristone labeling approved by the Food and Drug Administration in 2000, or the dosage included in the American College of Obstetricians and Gynecologists (ACOG) practice bulletin published in 2005. Both of these documents are out of date, and most US providers use a newer protocol that has been widely studied and found to be safe, effective and acceptable to patients [2, 3] . Yet even when the ACOG
doi:10.3410/f.718270044.793490589 fatcat:zceff333andqbl4yfqmyrcjleq