ImportanceThe Supreme Court decision in Dobbs v Jackson Women’s Health Organization overturned the right to choose abortion in the US, with at least 16 states subsequently implementing abortion bans or 6-week gestational limits. Prior research indicates that in the 6 months following Dobbs, approximately 32 360 fewer abortions were provided within the US formal health care setting. However, trends in the provision of medications for self-managed abortion outside the formal health care setting have not been studied.ObjectiveTo determine whether the provision of medications for self-managed abortion outside the formal health care setting increased in the 6 months after Dobbs.Design, Setting, and ParticipantsCross-sectional study using data from sources that provided abortion medications outside the formal health care setting to people in the US between March 1 and December 31, 2022, including online telemedicine organizations, community networks, and online vendors. Using a hierarchical bayesian model, we imputed missing values from sources not providing data. We estimated the change in provision of medications for self-managed abortion after the Dobbs decision. We then estimated actual use of these medications by accounting for the possibility that not all provided medications are used by recipients.ExposureAbortion restrictions following the Dobbs decision.Main Outcomes and MeasuresProvision and use of medications for a self-managed abortion.ResultsIn the 6-month post-Dobbs period (July 1 to December 31, 2022), the total number of provisions of medications for self-managed abortion increased by 27 838 (95% credible interval [CrI], 26 374-29 175) vs what would have been expected based on pre-Dobbs levels. Excluding imputed data changes the results only slightly (27 145; 95% CrI, 25 747-28 246). Accounting for nonuse of medications, actual self-managed medication abortions increased by an estimated 26 055 (95% CrI, 24 739-27 245) vs what would have been expected had the Dobbs decision not occurred.Conclusions and RelevanceProvision of medications for self-managed abortions increased in the 6 months following the Dobbs decision. Results suggest that a substantial number of abortion seekers accessed services despite the implementation of state-level bans and restrictions.

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多布斯诉杰克逊妇女健康组织决定前后为自我管理堕胎提供的药物

最高法院判决的重要性多布斯诉杰克逊妇女健康组织推翻了美国选择堕胎的权利，至少有 16 个州随后实施了堕胎禁令或 6 周妊娠限制。此前的研究表明，在接下来的 6 个月内多布斯，美国正规医疗机构内提供的堕胎数量减少了约 32,360 例。然而，尚未研究正规医疗机构之外自我管理堕胎药物的供应趋势。 目的 确定在正规医疗机构之外自我管理堕胎药物的提供是否在 6 个月内有所增加多布斯设计、设置和参与者横断面研究，使用的数据来自于 2022 年 3 月 1 日至 12 月 31 日期间在美国正规医疗机构之外向人们提供堕胎药物的来源，包括在线远程医疗组织、社区网络和在线供应商。使用分层贝叶斯模型，我们从不提供数据的来源中估算了缺失值。我们估计了自管理堕胎后药物供应的变化多布斯决定。然后，我们通过考虑并非所有提供的药物都被接受者使用的可能性来估计这些药物的实际使用情况。多布斯决定。主要成果和措施为自我管理堕胎提供和使用药物。结果在 6 个月后多布斯在此期间（2022 年 7 月 1 日至 12 月 31 日），用于自行管理堕胎的药物供应总数增加了 27 838 份（95% 可信区间 [CrI]，26 374-29 175），而基于预多布斯水平。排除估算数据后，结果仅略有变化（27 145；95% CrI，25 747-28 246）。考虑到不使用药物，实际自行管理的药物流产增加了估计 26 055 例（95% CrI，24 739-27 245），而如果多布斯未做出决定。 结论和相关性 自行管理堕胎的药物供应量在术后 6 个月内有所增加多布斯决定。结果表明，尽管实施了州级禁令和限制，仍有大量寻求堕胎的人获得了服务。