State restrictions on abortion are associated with fewer abortions in patients with high-risk cardiovascular conditions

Abstract

ObjectivesPatients with modified World Health Organization (mWHO) class IV cardiovascular conditions are at high risk of severe maternal morbidity and mortality in pregnancy and are advised to avoid pregnancy or consider abortion if they become pregnant. We aimed to determine if state-level abortion policy is associated with receiving an abortion in this high-risk population. Study designWe conducted a descriptive retrospective cross-sectional study of abortion among people 15-44 years of age with mWHO class IV cardiovascular conditionsstate policy on abortion using US claims data from United health Group from 2017 to 2020. ResultsThere was a statistically significant association between restrictive abortion policy at that state level and lower number of pregnancies ending in abortions in this high-risk group. ConclusionsStates with the most restrictive abortion policy have the lowest proportion of pregnancies ending in abortion among patients with mWHO class IV cardiovascular conditions. ImplicationsVariation in receiving abortion by state of residence among patients with mWHO class IV cardiovascular conditions may indicate an impending rise in severe maternal morbidity and mortality related to cardiovascular disease in pregnancy, and the risk factor is where a person lives. This trend may be exacerbated by the Supreme Court Decision Dobbs v Jackson Women’s Health.