Leveraging state hospital administrative data to assess the system-level impact of Dobbs on high-risk pregnancy care
Awarded 2023
High-risk pregnancy care, post-Dobbs
Erin McDaniel, MPH
University of Georgia

The Dobbs v Jackson Women’s Health Organization decision in June 2022 has created new burdens and restrictions around the provision of healthcare services that may be considered abortion through restrictive and vague state-level legislation implemented following the decision. Objective measures of the impact of abortion bans following Dobbs on obstetric care and pregnancy-related outcomes from statewide clinical data are needed to support policymakers and physicians. This project will leverage state-level hospital claims data to analyze trends, patterns of care, and outcomes for pregnant people experiencing pregnancy-related complications from 2018-2023. Complications analyzed include selected placental abnormalities, preterm premature rupture of the membranes, intrauterine infection, hemorrhage, and those arising from ectopic and molar pregnancies. We will assess trends, care, and outcomes within and between ten states: five states where abortion is completely banned or severely restricted (Arkansas, Georgia, Kentucky, Missouri, and South Dakota), and five states where abortion has remained legal and largely unrestricted (California, Colorado, Maryland, Michigan, and New York). We will also use spatial analysis to analyze changes in travel patterns for care. The results of this research aim to provide needed quantitative data documenting the immediate clinical impact of the Dobbs decision on patients presenting for care for pregnancy-related complications. This work may be used in a growing body of evidence documenting the harm caused by anti-abortion policies.