Texas Policy Evaluation Project

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The Texas Policy Evaluation Project, or TxPEP, is a collaborative group of university-based investigators who evaluate the impact of legislation in Texas related to women's reproductive health. It began in the fall of 2011 with the purpose of documenting and evaluating the impact of reproductive health legislation passed by the 82nd Texas Legislature. Those measures included large cuts to state family planning funding programs in the 2012–2013 budget as well as changes in the eligibility of organizations to participate in those programs, and Texas House Bill 15, a law requiring that women undergo a mandatory sonogram at least 24 hours before an abortion.

Contents

Their evaluation work continued after the 83rd Texas Legislature in 2013, when the legislature added funding streams for family planning to the 2014–15 budget and passed Texas House Bill 2, an omnibus bill restricting abortion care that was introduced in a special legislative session in summer 2013. HB 2 placed limits on medication abortion, banned abortion ≥20 weeks “post-fertilization,” and required abortion providers to have hospital admitting privileges and abortion facilities to meet the standards of ambulatory surgical centers (ASCs). In June 2016, the US Supreme Court struck down the admitting privileges and ASC requirements in HB 2, citing TxPEP research findings in its ruling.

The project continues to publish peer-reviewed journal articles on topics such as family planning, contraceptive counseling, abortion, judicial bypass for abortion, and more.

Researchers working on the project are affiliated with multiple institutions, including the University of Texas at Austin Population Research Center, the University of California San Francisco, and Ibis Reproductive Health. [1]

Researchers

Researchers involved with TxPEP include: [2]

Additional researchers can be found on the "Researchers" page of the TxPEP website.

Studies

The TxPEP research agenda includes studying the impact of the Supreme Court decision on abortion access in Texas, the effects of Texas House Bill 3994 in restricting judicial bypass for teens seeking abortion care without parental consent, as well as the impact of the new and reorganized state family planning programs and the Medicaid rule change permitting reimbursement for immediate postpartum provision of long-acting reversible contraception.

On November 17, 2015, TxPEP released a study that found that at least 100,000 Texas women between the ages of 18 and 49, and possibly as many as 240,000, had attempted to self-induce abortions at some point in their lives. [3] [4] On March 17, 2016, another study conducted by TxPEP researchers was published in the American Journal of Public Health . found that after HB 2 became law and some abortion clinics closed, women whose nearest clinic closed traveled on average 85 miles each way, compared to 22 miles each way for women whose nearest clinic did not close, and that women whose clinics closed were also more likely to spend more time obtaining an abortion. [5]

Publication List [6]

Baum, S. E., White, K., Hopkins, K., Potter, J. E., & Grossman, D. (2016). Women's experience obtaining abortion care in Texas after implementation of restrictive abortion laws: a qualitative study. PLOS ONE, 11(10), e0165048.

Baum, S. E., White, K., Hopkins, K., Potter, J. E., & Grossman, D. (2019). Rebound of medication abortion in Texas following updated mifepristone label. Contraception. https://doi.org/10.1016/j.contraception.2019.01.001

Coleman-Minahan, K., Aiken, A. R., & Potter, J. E. (2017). Prevalence and predictors of prenatal and postpartum contraceptive counseling in two Texas cities. Women's Health Issues, 27(6), 707–714. https://doi.org/10.1016/j.whi.2017.05.004

Coleman‐Minahan, K., Dillaway, C. H., Canfield, C., Kuhn, D. M., Strandberg, K. S., & Potter, J. E. (2018). Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit. Perspectives on sexual and reproductive health, 50(4), 189–198. https://doi.org/10.1363/psrh.12083

Coleman-Minahan, K., Stevenson, A. J., Obront, E., & Hays, S. (2019). Young women's experiences obtaining judicial bypass for abortion in Texas. Journal of Adolescent Health, 64(1), 20–25. https://doi.org/10.1016/j.jadohealth.2018.07.017

Fuentes, L., Lebenkoff, S., White, K., Gerdts, C., Hopkins, K., Potter, J. E., & Grossman, D. (2016). Women's experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas. Contraception, 93(4), 292–297. http://doi.org/10.1016/j.contraception.2015.12.017

Gerdts, C., Fuentes, L., Grossman, D., White, K., Keefe-Oates, B., Baum, S., Hopkins, K., Stolp C. W., Potter, J. E. (2016). The impact of clinic closures on women obtaining abortion services after implementation of a restrictive law in Texas. American Journal of Public Health, 106(5), 857–864. https://doi.org/10.2105/AJPH.2016.303134

Goyal, V., Canfield, C., Aiken, A. R., Dermish, A., & Potter, J. E. (2017). Postabortion contraceptive use and continuation when long-acting reversible contraception is free. Obstetrics and gynecology, 129(4), 655.

Grossman, D., Baum, S., Fuentes, L., White, K., Hopkins, K., Stevenson, A. J., & Potter, J. E. (2014). Change in abortion services after implementation of a restrictive law in Texas. Contraception, 90(5), 496–501. http://doi.org/10.1016/j.contraception.2014.07.006

Grossman, D., White, K., Hopkins, K., & Potter, J. E. (2014). The public health threat of anti-abortion legislation. Contraception, 89(2), 73–4. http://doi.org/10.1016/j.contraception.2013.10.012

Grossman, D., White, K., Hopkins, K., & Potter, J. E. (2017). Change in distance to nearest facility and abortion in Texas, 2012 to 2014. Jama, 317(4), 437–439.

Hendrick, C. E., & Potter, J. E. (2017). Nativity, Country of Education, and Mexican‐Origin Women's Breastfeeding Behaviors in the First 10 Months Postpartum. Birth, 44(1), 68–77. https://doi.org/10.1111/birt.12261

Hopkins, K., Hubert, C., Coleman-Minahan, K., Stevenson, A. J., White, K., Grossman, D., & Potter, J. E. (2018). Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas. Journal of American College Health, 66(5), 360–368. https://doi.org/10.1080/07448481.2018.1431901

Hopkins, K., White, K., Linkin, F., Hubert, C., Grossman, D., & Potter, J. E. (2015). Women's experiences seeking publicly funded family planning services in Texas. Perspectives on Sexual and Reproductive Health, 47(2), 63–70. http://doi.org/10.1363/47e2815

Potter, J. E., Coleman-Minahan, K., White, K., Powers, D. A., Dillaway, C., Stevenson, A. J., ... & Grossman, D. (2017). Contraception after delivery among publicly insured women in Texas: use compared with preference. Obstetrics and gynecology, 130(2), 393.

Potter, J. E., Hopkins, K., Aiken, A. R. A., Hubert, C., Stevenson, A. J., White, K., & Grossman, D. (2014). Unmet demand for highly effective postpartum contraception in Texas. Contraception, 90(5), 488–95. http://doi.org/10.1016/j.contraception.2014.06.039

Potter, J. E., Hubert, C., Stevenson, A. J., Hopkins, K., Aiken, A. R. A., White, K., & Grossman, D. (2016). Barriers to postpartum contraception in Texas and pregnancy within 2 years of delivery. Obstetrics & Gynecology, 127(2), 289–296. http://doi.org/10.1097/AOG.0000000000001201

Potter, J. E., Hubert, C., & White, K. (2017). The availability and use of postpartum LARC in Mexico and among Hispanics in the United States. Maternal and child health journal, 21(9), 1744–1752. https://doi.org/10.1007/s10995-016-2179-6

Potter, J. E., Stevenson, A. J., Coleman-Minahan, K., Hopkins, K., White, K., Baum, S. E., & Grossman, D. (2019). Challenging unintended pregnancy as an indicator of reproductive autonomy. Contraception. https://doi.org/10.1016/j.contraception.2019.02.005

Stevenson, A. J. (2014). Finding the Twitter users who stood with Wendy. Contraception, 90(5), 502–507. http://doi.org/10.1016/j.contraception.2014.07.007

Stevenson, A. J., Flores-Vazquez, I. M., Allgeyer, R. L., Schenkkan, P., & Potter, J. E. (2016). Effect of removal of Planned Parenthood from the Texas Women's Health Program. New England Journal of Medicine, 374(9), 853–860. http://doi.org/10.1056/NEJMsa1511902

White, K., Adams, K., & Hopkins, K. (2019). Counseling and referrals for women with unplanned pregnancies at publicly funded family planning organizations in Texas. Contraception, 99(1), 48–51. https://doi.org/10.1016/j.contraception.2018.09.006

White, K., Baum, S. E., Hopkins, K., Potter, J. E., & Grossman, D. (2019). Change in Second-Trimester Abortion After Implementation of a Restrictive State Law. Obstetrics & Gynecology, 133(4), 771–779.

White, K., Campbell, A., Hopkins, K., Grossman, D., & Potter, J. E. (2017). Barriers to Offering Vasectomy at Publicly Funded Family Planning Organizations in Texas. American journal of men's health, 11(3), 757–766. https://doi.org/10.1177%2F1557988317694296

White, K., Carroll, E., & Grossman, D. (2015). Complications from first-trimester aspiration abortion: a systematic review of the literature. Contraception, 92(5), 422–438. http://doi.org/10.1016/j.contraception.2015.07.013

White, K., Grossman, D., Hopkins, K., & Potter, J. E. (2012). Cutting family planning in Texas. New England Journal of Medicine, 367(13), 1179–1181. http://doi.org/10.1056/Nejmp1207920

White, K., Grossman, D., Stevenson, A. J., Hopkins, K., & Potter, J. E. (2017). Does information about abortion safety affect Texas voters' opinions about restrictive laws? A randomized study. Contraception, 96(6), 381–387. https://doi.org/10.1016/j.contraception.2017.08.007

White, K., Hopkins, K., Aiken, A. R. A., Stevenson, A. J., Hubert, C., Grossman, D., & Potter, J. E. (2015). The impact of reproductive health legislation on family planning clinic services in Texas. American Journal of Public Health, 105(5), 851–8. http://doi.org/10.2105/AJPH.2014.302515

White, K., Hopkins, K., Grossman, D., & Potter, J. E. (2018). Providing family planning services at primary care organizations after the exclusion of Planned Parenthood from publicly funded programs in Texas: early qualitative evidence. Health services research, 53, 2770–2786. https://doi.org/10.1111/1475-6773.12783

White, K., Potter, J. E., Stevenson, A. J., Fuentes, L., Hopkins, K., & Grossman, D. (2016). Women's knowledge of and support for abortion restrictions in Texas: findings from a statewide representative survey. Perspectives on Sexual and Reproductive Health, 48(4). http://doi.org/10.1363/48e8716

Woo, C. J., Alamgir, H., & Potter, J. E. (2016). Women's experiences after Planned Parenthood's exclusion from a family planning program in Texas. Contraception, 93(4), 298–302. http://doi.org/10.1016/j.contraception.2015.12.004

Related Research Articles

Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion" and occurs in approximately 30% to 40% of pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. Although it prevents the birth of a child, abortion is not generally considered birth control.

Dilationand curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a gynecologic procedure used for diagnostic and therapeutic purposes, and is the most commonly used method for first-trimester miscarriage or abortion.

Misoprostol Medication to induce abortion and treat ulcers

Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. Misoprostol is taken by mouth when used to prevent gastric ulcers in persons taking NSAIDs. For abortions it is used by itself and with mifepristone or methotrexate. By itself, effectiveness for abortion is between 66% and 90%. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.

Dilation and evacuation (D&E) is the dilation of the cervix and surgical evacuation of the uterus after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.

Self-induced abortion Abortion performed by a pregnant person themselves outside the recognized medical system

A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.

Hormonal IUDs

Intrauterine system (IUS) with progestogen, sold under the brand name Mirena among others, is an intrauterine device that releases the hormone levonorgestrel into the uterus. It is used for birth control, heavy menstrual periods, and to prevent excessive build of the lining of the uterus in those on estrogen replacement therapy. It is one of the most effective forms of birth control with a one-year failure rate around 0.2%. The device is placed in the uterus and lasts three to seven years. Fertility often returns quickly following removal.

Reproductive justice Social justice movement

Reproductive justice is "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities," according to SisterSong Women of Color Reproductive Justice Collective, the first organization founded to build a reproductive justice movement. In 1997, 16 women-of-color-led organizations representing four communities of color – Native American, Latin American, African American, and Asian American – launched the nonprofit SisterSong to build a national reproductive justice movement. Additional organizations began to form or reorganize themselves as reproductive justice organizations starting in the early 2000s.

Contraceptive implant Implantable medical device used for birth control

A contraceptive implant is an implantable medical device used for the purpose of birth control. The implant may depend on the timed release of hormones to hinder ovulation or sperm development, the ability of copper to act as a natural spermicide within the uterus, or it may work using a non-hormonal, physical blocking mechanism. As with other contraceptives, a contraceptive implant is designed to prevent pregnancy, but it does not protect against sexually transmitted infections.

Women on Web Canadian online abortion help service

Women on Web (WoW) is a Canadian non-profit organization that provides access to safe abortion services to protect women's health and lives. People who need access to safe abortion can do an online consultation on the Women on Web website and request abortion pills from their medical team. Women on Web helpdesk provides information and support in 16 languages, including Arabic, English, French, German, Japanese, Korean, Hungarian, Indonesian, Italian, Persian, Polish, Portuguese, Russian, Spanish, Thai, and Turkish. The organization was founded by Dr. Rebecca Gomperts, a Dutch physician, in 2005.

Birth control Method of preventing human pregnancy

Birth control, also known as contraception, anticonception, and fertility control, is a method or device used to prevent pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th century. Planning, making available, and using birth control is called family planning. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable. The term birth control is a bit of a misnomer since abortion is not regularly considered under the term.

Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception.

Intrauterine device Form of birth control involving a device placed in the uterus

An intrauterine device (IUD), also known as intrauterine contraceptive device or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control (LARC). One study found that female family planning providers choose LARC methods more often (41.7%) than the general public (12.1%). Among birth control methods, IUDs, along with other contraceptive implants, result in the greatest satisfaction among users.

Ipas (organization)

Ipas is an international, non-governmental organization that increases access to safe abortions and contraception. To this end the organization informs women how to obtain safe and legal abortions and trains relevant partners in Africa, Asia, and Latin America on how to provide and advocate for these.

Reproductive coercion is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and control related to reproductive health by a current, former, or hopeful intimate or romantic partner, but they can also be perpetrated by parents or in-laws. Coercive behaviors infringe on individuals' reproductive rights and reduce their reproductive autonomy.

A medical abortion, also known as medication abortion, occurs when medically-prescribed drugs (medication) are used to bring about an abortion. A typical regimen consists of a combination of medications, with mifepristone followed by misoprostol being the most common abortifacient regimen. Mifepristone followed by misoprostol for abortion is considered both safe and effective throughout a range of gestational ages. When mifepristone is not available, misoprostol alone may be used. In addition to mifepristone/misoprostol, other medications may be used depending on availability and patient-specific considerations.

Women's reproductive health in the United States refers to the set of physical, mental, and social issues related to the health of women in the United States. It includes the rights of women in the United States to adequate sexual health, available contraception methods, and treatment for sexually transmitted diseases. The prevalence of women's health issues in American culture is inspired by second-wave feminism in the United States. As a result of this movement, women of the United States began to question the largely male-dominated health care system and demanded a right to information on issues regarding their physiology and anatomy. The U.S. government has made significant strides to propose solutions, like creating the Women's Health Initiative through the Office of Research on Women's Health in 1991. However, many issues still exist related to the accessibility of reproductive healthcare as well as the stigma and controversy attached to sexual health, contraception, and sexually transmitted diseases.

Maternal healthcare in Texas

Maternal healthcare in Texas refers to the provision of family planning services, abortion options, pregnancy-related services, and physical and mental well-being care for women during the prenatal and postpartum periods. The provision of maternal health services in each state can prevent and reduce the incidence of maternal morbidity and mortality and fetal death.

Daniel Grossman is an American obstetrician, gynecologist, and medical researcher. He is a professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the University of California, San Francisco, where he is also the director of the collaborative research group Advancing New Standards in Reproductive Health (ANSIRH). He is also an investigator for the Texas Policy Evaluation Project (TxPEP) and a senior advisor at Ibis Reproductive Health. In 2013, he received the Felicia Stewart Advocacy Award from the American Public Health Association.

Paul D. Blumenthal is an American physician, researcher, cervical cancer prevention advocate, and abortion provider who is certified in obstetrics and gynecology. He is known for his cervical cancer, abortion, and contraception research. He is also known for his commitment to international women’s health—evidenced by his contribution to public health initiatives in over 30 countries.

The Society of Family Planning (SFP) is an international non-profit professional organization established in 2005 specializing in "abortion and contraception science" composed of physicians, nurses, sociologists, public health practitioners and trainees in these fields. The majority of member physicians include specialists of obstetrics and gynecology, family medicine, and adolescent medicine.

References

  1. ↑ "About TxPEP". University of Texas. Retrieved 19 March 2016.
  2. ↑ "The Researchers". University of Texas. Retrieved 19 March 2016.
  3. ↑ "At Least 100,000 Texas Women Have Attempted Abortion Self-Induction". University of Texas. 17 November 2015. Retrieved 19 March 2016.
  4. ↑ Levintova, Hannah (17 November 2015). "Up to 240,000 Women Have Tried to Give Themselves Abortions in Texas". Mother Jones. Retrieved 19 March 2016.
  5. ↑ Gerdts, Caitlin; Fuentes, Liza; Grossman, Daniel; White, Kari; Keefe-Oates, Brianna; Baum, Sarah E.; Hopkins, Kristine; Stolp, Chandler W.; Potter, Joseph E. (17 March 2016). "Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Law in Texas". American Journal of Public Health. 106 (5): e1–e8. doi:10.2105/AJPH.2016.303134. PMC   4985084 . PMID   26985603.
  6. ↑ "UT College of Liberal Arts: TxPEP".
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