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Changes in Abortion in Texas Following an Executive Order Ban During the Coronavirus Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

In response to the coronavirus disease 2019 pandemic, Texas Governor Greg Abbott issued an executive order on March 22, 2020, postponing surgeries and procedures that were not medically necessary.1 Texas officials interpreted this to prohibit most abortions until the order expired on April 21, 2020, contrary to medical associations’ recommendations.2

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Article Information

Accepted for Publication: November 17, 2020.

Published Online: January 4, 2021. doi:10.1001/jama.2020.24096

Corresponding Author: Kari White, PhD, MPH, 1925 San Jacinto Blvd, Stop D3500, Austin, TX 78712 (kariwhite@utexas.edu).

Author Contributions: Dr White had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: White, Kumar, Goyal, Roberts, Grossman.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: White, Kumar.

Critical revision of the manuscript for important intellectual content: Kumar, Goyal, Wallace, Roberts, Grossman.

Statistical analysis: White.

Obtained funding: White, Roberts, Grossman.

Administrative, technical, or material support: Goyal, Grossman.

Supervision: Kumar.

Conflict of Interest Disclosures: Dr Wallace was a named plaintiff in the case Planned Parenthood Center for Choice v Abbott. No other disclosures were reported.

Funding/Support: This research was supported by a grant from the Susan Thompson Buffett Foundation and grant P2CHD042849 awarded to the Population Research Center at the University of Texas at Austin from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily reflect the views of the Planned Parenthood Federation of America.

Additional Contributions: We thank Lina Palomares, LMSW, Gracia Sierra, PhD, and Elsa Vizcarra, BS, all at the University of Texas at Austin, for assistance with data acquisition and management, for which they received no additional compensation for their role in this study. We also thank the facilities that provided data on abortion patients.

Additional Information: Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, provided information about abortion facilities in other states.

References
1.
Ken Paxton, Attorney General of Texas. Health care professionals and facilities, including abortion providers, must immediately stop all medically unnecessary surgeries and procedures to preserve resources to fight COVID-19 pandemic [press release]. Published March 23, 2020. Accessed October 21, 2020. https://www.texasattorneygeneral.gov/news/releases/health-care-professionals-and-facilities-including-abortion-providers-must-immediately-stop-all
2.
American College of Obstetricians and Gynecologists. Joint statement on abortion access during the COVID-19 outbreak [press release]. Published March 18, 2020. Accessed October 21, 2020. https://www.acog.org/news/news-releases/2020/03/joint-statement-on-abortion-access-during-the-covid-19-outbreak
3.
White  K , Sierra  G , Vizcarra  E ,  et al. The Potential Impact of Texas’ Executive Order on Patients’ Access to Abortion Care. Texas Policy Evaluation Project; 2020. Accessed June 14, 2020. http://sites.utexas.edu/txpep/files/2020/04/TxPEP-research-brief-executive-order-abortion-delay-4-8-20.pdf
4.
Baum  SE , White  K , Hopkins  K , Potter  JE , Grossman  D .  Rebound of medication abortion in Texas following updated mifepristone label.   Contraception. 2019;99(5):278-280. doi:10.1016/j.contraception.2019.01.001PubMedGoogle ScholarCrossref
5.
Aiken  ARA , Starling  JE , Gomperts  R , Tec  M , Scott  JG , Aiken  CE .  Demand for self-managed online telemedicine abortion in the United States during the coronavirus disease 2019 (COVID-19) pandemic.   Obstet Gynecol. 2020;136(4):835-837. doi:10.1097/AOG.0000000000004081PubMedGoogle ScholarCrossref
6.
Upadhyay  UD , Desai  S , Zlidar  V ,  et al.  Incidence of emergency department visits and complications after abortion.   Obstet Gynecol. 2015;125(1):175-183. doi:10.1097/AOG.0000000000000603PubMedGoogle ScholarCrossref
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