Work

The impact of legislative changes on abortion care: A retrospective study of one hospital system in North Carolina

Year: 2026

Type: article

Abstract: OBJECTIVES: North Carolina is unique as a southeastern state that provides abortion access for the region and implemented a 12 week ban one year after the Dobbs decision. This study sought to compare demographics, gestational duration (GD), and clinical characteristics of abortion patients across three time frames corresponding to federal and state-level policy changes. We compared in-state to out-of-state patients at one North Carolina hospital system between July 2021 and June 2024. STUDY DESIGN: We conducted a quasi-experimental retrospective cohort study using electronic health record data, comparing patient characteristics and clinical outcomes across three distinct time periods. Analyses were stratified by residency (in-state versus out-of-state) to evaluate differential impacts over time. Patients were grouped by date: the year before Dobbs (July 2021-June 2022), the year after Dobbs (July 2022-June 2023), and the year after SB20 (July 2023-June 2024). We used descriptive statistics and regression models. RESULTS: Of 929 patients, 291 were pre-Dobbs, 306 were post-Dobbs, and 333 were post-SB20 with average GDs of 14.9, 13.5, and 9.7 weeks, respectively. Out-of-state patients were 1.6 (OR = 1.57, 95% CI 1.04-2.39) times as likely to have a risk factor for an abortion complication. Time frame and state of residence were significant predictors of GD (p < 0.001) but did not predict complications. CONCLUSIONS: Despite a 12 week abortion ban in North Carolina, out-of-state patients continued to seek care at a significantly higher GD which is associated with a higher risk of complications in prior literature.

Source: Sexual & Reproductive Healthcare

DOI: 10.1016/j.srhc.2026.101207

Authors: Morgan E. Johnson, Jessica E. Morse, Amy Bryant

Institutions: University of North Carolina at Chapel Hill, University of North Carolina Health Care

Language: English

Topic: Reproductive Health and Contraception

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $1,850