Abortion provision and characteristics of abortion patients in an academic medical center in Washington state before and after Dobbs

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OBJECTIVE: To examine abortion care in the largest academic medical center in Washington, a state protective of abortion rights, before and after the Supreme Court Dobbs decision. METHODS: This retrospective cohort study evaluated abortion provision at the University of Washington between January 1, 2022 and October 31, 2023. Data on patient sociodemographic and clinical characteristics were extracted from electronic medical records. We assessed differences in patient sociodemographics, clinical characteristics, and type of care (medication vs. procedural) comparing the pre-Dobbs (January 1, 2022- June 23, 2022) and post-Dobbs (June 24, 2022 - October 31, 2023) periods using chi-squared tests for categorical variables and t-tests for continuous variables. RESULTS: Among the 494 abortions performed during the study period, most were procedural (63%) and performed in the hospital setting (68%), over one-third (37%) had a fetal anomaly, and 4% were among individuals from out of state. The distribution of gestational duration was bimodal: over one-third of abortions occurred at less than 8 weeks gestation (34%) and 38% were 18 weeks or greater. The weekly number of abortions remained stable and there were minimal significant differences in patient characteristics or type of care comparing the pre-and-post Dobbs periods. CONCLUSION: Academic medical centers provide comprehensive abortion services that span primary to complex specialty care. The minimal changes in abortion care following Dobbs suggests academic medical centers have important patient care and training opportunities to expand abortion access in Washington state.

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