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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. [ABSTRACT FROM AUTHOR]

Background: Women of reproductive age who binge drink or have alcohol-related problem symptoms (APS) and who do not use contraception are considered at risk of an alcohol-exposed pregnancy (AEP). In the U.S., efforts to prevent AEPs focus largely on delivering interventions in primary health care settings. While research suggests that these interventions are efficacious for women reached, it is unclear to what extent these interventions are likely to reach women at risk of AEPs.Methods: Data are from the Turnaway Study, a study of 956 women seeking pregnancy termination at 30 U.S. facilities between 2008 and 2010, some of whom received and some of whom were denied terminations because they were past the gestational limit. We examined associations between binge drinking, APS, and drug use prior to pregnancy recognition and having a usual source of health care (USOC).Results: Overall, 59% reported having a USOC. A smaller proportion with than without an APS reported a USOC (44 vs. 60%, p<.05) and a smaller proportion using than not using drugs reported a USOC (51 vs. 61%, p<.05). This pattern was not observed for binge drinking. In multivariate analyses, an APS continued to be associated with lack of a USOC, while drug use was no longer associated with lack of a USOC.Conclusions: As more than 40% did not have a USOC, with higher proportions among women with an APS, primary health-care based approaches to AEP prevention seem unlikely to reach the majority of women who have an APS and are at risk of an unintended pregnancy. [ABSTRACT FROM AUTHOR]

Background: Women who terminate pregnancies drink more subsequent to the pregnancy than women who give birth, including women who give birth after seeking to terminate a pregnancy., Methods: Data are from the Turnaway Study, a prospective, longitudinal study of 956 women who sought to terminate pregnancies at 30 U.S. facilities. This paper focuses on the 452 women who received terminations just below facility gestational limits and 231 who were denied terminations because they presented just beyond facility gestational limits. This study examined whether baseline characteristics moderate the relationship between termination and subsequent binge drinking and whether stress, feelings about the pregnancy, and number of social roles mediate the relationship., Results: Only having had a previous live birth modified the termination-binge drinking relationship. Among women with previous live births, binge drinking was reduced among women carrying to term compared to terminating the pregnancy. Among women who had not had a previous live birth, however, the reduction in binge drinking among those denied termination was not sustained over time, and binge drinking of those who had and had not had terminations converged by 2.5 years. Neither stress, negative emotions, nor social roles mediated effects on binge drinking. Positive emotions at one week mediated effects on binge drinking at six months, although positive emotions at two years did not mediate effects on binge drinking at 2.5 years., Conclusions: Higher levels of binge drinking among those who terminate pregnancies do not appear due to stress or to negative emotions. Only parous women - and not nulliparous women - denied terminations experienced sustained reductions in binge drinking over time., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)