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Background: Popular support for access to abortion and contraceptive services is often based on the idea that they will help women determine the trajectory of their life course. This study examined whether receiving versus being denied an abortion affects aspirational life goal setting and attainment 5 years later., Methods: We compared women who sought and were denied an abortion because they were 3 weeks beyond the gestational limit ('Parenting-Turnaways') to those who received an abortion in the first trimester ('First-Trimesters'); received an abortion within 2 weeks of the facility's gestational limit ('Near-Limits'); and sought an abortion, were turned away and received an abortion elsewhere or placed their baby for adoption ('Non-Parenting-Turnaways'). We used mixed effects logistic regression analyses to estimate the odds of setting an aspirational plan and to estimate the odds of both setting and achieving an aspirational 5-year plan., Results: At 1 week post abortion-seeking, 791 women reported 1864 5-year plans, most of which were aspirational (n=1692, 91%). Parenting-Turnaways had lower odds of setting an aspirational 5-year plan than Near-Limits (OR 0.36, 95% CI 0.18 to 0.73). There were no differences by group in achieving aspirational 5-year plans among those who had them., Conclusions: Soon after abortion-seeking, women denied a wanted abortion were less optimistic about their long-term futures than women who received a wanted abortion. Abortion access can help women set positive long-term goals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Seventeen percent of women in the United States experience more than one unintended pregnancy in their lifetimes. However, few studies examine how the resolution of unintended pregnancy, whether in birth or abortion, affects the likelihood of a subsequent unintended pregnancy. Our objective was to determine whether receiving or being denied a wanted abortion is associated with subsequent unintended pregnancy., Methods: The Turnaway Study, a 5-year, prospective cohort study, followed women who sought an abortion at one of 30 abortion facilities across the United States between 2008 and 2010. Secondary analysis of the Turnaway data analyzed the effects of various factors on time to subsequent unintended pregnancy., Results: By 5 years, the rate of unintended pregnancy was 42 per 100 women with no difference between those who received and those who were denied a wanted abortion. Women aged 35 to 46 years (vs those aged 20-24 years), women with a college degree (vs women who had completed high school or obtained a general education diploma), and foreign-born (vs native-born) women had a reduced rate of a subsequent unplanned pregnancy (adjusted hazard ratio [AHR], 0.30; 95% confidence interval [CI], 0.16-0.57; AHR, 0.54, 95% CI, 0.30-0.97; AHR, 0.44; 95% CI, 0.25-0.77, respectively). Higher parity and a history of depression were positively associated with a higher rate of subsequent unintended pregnancy. There was no difference in the outcomes of these unintended pregnancies by study group; approximately one-sixth ended in miscarriage and one-quarter of subsequent unintended pregnancies ended in abortion., Discussion: Neither receiving nor being denied abortion is associated with subsequent unintended pregnancy risk. Other factors such as nativity, parity, age, and mental health history are associated with multiple unintended pregnancies. Ensuring access to abortion services will not increase the likelihood that women will experience subsequent unintended pregnancies., (© 2018 by the American College of Nurse-Midwives.)

Background: In 2014, Louisiana passed a law requiring abortion providers to have hospital admitting privileges. This law is temporarily on hold while a court case challenging it continues. We aimed to describe the population who would be affected if the law goes into effect and how closures of between three and five Louisiana abortion facilities would affect the distance Louisiana women would need to travel for an abortion., Study Design: We abstracted patient data from three of the five Louisiana abortion care facilities in the year before the law was scheduled to take effect. We then estimated distance traveled and distances women would need to travel if clinics close., Findings: Half (53%) of women who had an abortion had no education beyond high school, most were black (62%) or white (30%), three fourths (73%) had a previous live birth, and most (89%) were having a first-trimester abortion. Seventy-nine percent resided in Louisiana and 15% in Texas. The parishes in which abortion patients resided had lower median income and higher percentage poverty than the Louisiana average. Abortion patients residing in Louisiana traveled a mean distance of 58 miles each way for an abortion. If all Louisiana facilities close, the mean distance women would need to travel would more than triple to 208 miles, and the proportion of Louisiana women of reproductive age who live more than 150 miles from an abortion facility would increase from 1% to 72%., Conclusion: The admitting privileges law will likely significantly increase the distance Louisiana women need to travel for an abortion. This burden is likely to disproportionately affect Louisiana's more vulnerable residents., Implications: If all Louisiana abortion facilities close due to Louisiana's hospital admitting privileges law, the mean distance women would need to travel for an abortion would more than triple from 58 to 208 miles. Louisiana's law would thus present a considerable burden on many Louisiana women, particularly those who are more vulnerable., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The article provides information on the study "Denial of Abortion Because of Provider Gestational Age Limits in the U.S." by Ushma D. Upadhyay and colleagues, which examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. Topics discussed include methodology of the study, reasons for delay and access barriers, and factors associated with obtaining an abortion after being denied one.