Trends in utilization of an anonymous abortion and miscarriage hotline before and after <i>Dobbs v. Jackson Women's Health Organization</i>: a retrospective cohort study.

Redd, Sara K; Gavidia, Alexandra A; Jones, Taylor; Dillon, Sage; Luke, Alina A; Murphy, Emma Chew; Arzate, Marissa J; Martinez, Ashley et al. · Lancet Reg Health Am · 2026

retrospective_cohort · Level III

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Abstract

The <i>Dobbs v. Jackson Women's Health Organization</i> decision significantly altered abortion access in the U.S., increasing reliance on resources outside the formal healthcare system. This study examined utilization of a medical hotline supporting people managing their abortions and miscarriages, comparing trends before and after <i>Dobbs</i>. We conducted a retrospective cohort analysis of de-identified data of US-based English and Spanish-speaking individuals contacting the Miscarriage and Abortion (M + A) Hotline between June 24, 2021 (one year pre-<i>Dobbs</i>) and June 24, 2023 (one year post-<i>Dobbs</i>). We assessed changes in contact volume, characteristics, and reason for contact over time and by state abortion ban status using descriptive statistics. We applied comparative interrupted time series analyses to test the association of <i>Dobbs</i> with changes in Hotline contacts across state abortion policy environments. Among 16,429 unique Hotline contacts, 4009 (24%) occurred pre-<i>Dobbs</i> and 12,420 (76%) post-<i>Dobbs,</i> a 210% increase (<i>p</i> < 0.001). Pre-<i>Dobbs</i>, Hotline contacts increased 10% per month in no-ban states (<i>p</i> < 0.001). While baseline contact levels were comparable between ban and no-ban states, pre-<i>Dobbs</i> trends diverged significantly, with ban states experiencing 7% higher increases in monthly contacts (<i>p</i> < 0.001). Immediately post-<i>Dobbs</i>, monthly Hotline contact levels did not differ between ban and no-ban states; post-<i>Dobbs</i> trends diverged modestly between groups (<i>p</i> < 0.05). Hotline use was increasing rapidly prior to <i>Dobbs</i>-particularly in states that later enacted bans-indicating substantial unmet need preceding the policy change. Post-<i>Dobbs</i>, trends diverged modestly without an immediate surge, suggesting a more complex response than a simple policy-driven increase and underscoring persistent gaps in reproductive healthcare access. Society of Family Planning, the Center for Reproductive Health Research in the Southeast, and the US National Institutes of Health.