ABSTRACTS
Obstetric Emergencies: Prehospital Trends and Associations After the Overturning of Roe v. WadeAuthor: Morgan Anderson, MPH | | Associate Authors: Alyssa M. Green, MS, Megan Marino, MD, FAAP, Emily Nichols, MD, FACEP
Introduction Prior studies have suggested that the overturning of Roe vs. Wade (RvW) would disproportionately impact minorities and impoverished women in areas of reproductive health. Objective To describe obstetrical emergency (OE) incidents and compare incidents with differing abortion access after the overturning of Roe v. Wade. Methods We conducted a retrospective analysis of EMS patient care records with 9-1-1 response for 12- to 50-year-old females from the ImageTrend Collaborate dataset across an 11-month time span after Roe v. Wade was overturned (June 24, 2022–May 24, 2023). Incident location was grouped by statewide abortion access; county Medicaid usage data was used to evaluate levels of poverty. We described incident characteristics, compared proportions across abortion access groups, and utilized multivariable logistic regression (aOR, 95% CI) to identify associations between OE and incident characteristics. Results A total of 32,474 9-1-1 obstetric incidents occurred after the overturning of Roe v. Wade. A majority of incidents occurred in the 25- to 34-year age group (46.4%), were Black or African American (43.8%), had a dispatch reason of pregnancy/childbirth/miscarriage (81.7%), were treated and transported (79.8%), occurred in metro areas (91.1%), had lower acuity (70.1%), and occurred in low-poverty areas (59.1%). Abdominal and pelvic pain was the most documented primary provider impression (22.8%) and primary symptom (34.3%). OEs were more likely to occur in Black or African Americans (2.28, 95% CI: 2.14–2.36), Hispanics (1.69, 95% CI: 1.63–1.76), and other/multiple races (1.52, 95% CI: 1.45–1.60) compared to Whites, incident locations without access to abortions (1.27, 95% CI: 1.23–1.31); some access (1.19, 95% CI: 1.15–1.24) compared to open access states (21–30%, 1.11, 95% CI: 1.08–1.15) and in counties where Medicaid usage was above 20% (> 31%, 1.50, 95% CI: 1.42–1.58). Conclusion This analysis showed OEs disproportionately impacted Black or African American women, those living in states with no abortion access, and those in areas with higher poverty levels. Evidence further shows that these incidents are of lower acuity, indicating the need for improved access to prenatal and primary care in these areas to reduce the utilization of EMS for preventable obstetric events. Further research is required to determine if these results are associated with the overturning Roe v. Wade.
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