Implications of <i>Dobbs v.</i> Jackson for patients and providers: a scoping review
Bibliographic record
Abstract
Abstract Introduction On June 24, 2022, the U.S. Supreme Court’s decision in Dobbs v. Jackson overturned the right to abortion set forth by Roe v. Wade , granting states the authority to regulate access to abortion services. This has led to widespread bans, threatening patients’ access to, and healthcare providers’ abilities to provide, the full spectrum of reproductive health services. The ruling disproportionately affects marginalized groups, exacerbating existing social disparities in health and is an emerging public health crisis. Methods We conducted a scoping review to evaluate the impact of Dobbs on patients’ health outcomes and access to health services, as well as on medical trainees’ and healthcare providers’ ability to access abortion training and provide reproductive health services. The search was based on the PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched eight bibliographic databases (PubMed, Scopus, Embase, PsycINFO, Google Scholar, Science Direct, JSTOR, and Web of Science) and three preprint servers (medRxiv, bioRxiv, and Europe PMC) using various combinations of keywords related to ‘abortion’ and ‘Dobbs v. Jackson’ on March 22, 2023. Four reviewers independently screened the studies based on pre-specified eligibility criteria and one reviewer performed data extraction for pre-identified themes. Results A total of 18 studies met the inclusion criteria. We found that Dobbs led to a surge in demand for contraception, compounded existing travel- and cost-related barriers to access, increased polarizing views on social media (e.g., Twitter), and evoked significant fears and concerns among medical trainees regarding their scope of practice and fears of legal repercussions for offering standard-of-care and related services to patients seeking abortions. Conclusion Our study offers valuable insights into the clinical implications of Dobbs on patients’ health outcomes and access to health services, as well as providers’ reproductive health practices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.089 | 0.364 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.027 | 0.027 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.009 | 0.009 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".