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Supporting Abortion Access Post-Dobbs: Understanding U.S. Challenges and Helping Patients Access Abortion in LA County

Earn CME by watching the related webinar

Susie Baldwin, MD, MPH, FACPM
Erika Martinez Abad, MPH
The Office of Women’s Health Team

November 20, 2025

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Key Points

  • Access to abortion is a significant public health and reproductive justice issue.
  • Barriers to abortion disproportionately impact the most marginalized and economically disadvantaged people in our society.
  • Abortion bans are contributing to preventable illness and death from conditions including miscarriage, ectopic pregnancy, and fetal demise, as well as limiting access to abortion.
  • The Abortion Safe Haven (ASH) Project aims to ensure that abortion services are accessible for anyone who needs them in LA County, including visitors from other jurisdictions.
  • Healthcare providers can use the Abortion Safe Haven website to access educational materials and resources to expedite referrals for their patients.
  • Public Health’s free on-demand CME webinar, Abortion Facts and Resources: A Guide for Medical Providers, covers the impacts of abortion access and harms of criminalization, addresses abortion misinformation, and enables healthcare providers to streamline referral processes for pregnancy options counseling and/or abortion care.

 

Access to Abortion is a Public Health Issue

Access to abortion is fundamental to the health of individuals, families, and communities and is a significant public health issue. In the United States, abortion is common and extremely safe.1,2,3,4 However, access to abortion care has become increasingly banned or restricted, making it difficult for many people to obtain timely services.

Access to abortion is also a key reproductive justice issue, essential to ensuring that people can maintain autonomy over their bodies, pregnancies, and lives. Reproductive justice includes the right to decide whether and when to have children, and the ability to raise those children in safe and sustainable communities.5

Barriers to abortion disproportionately impact the most marginalized and economically disadvantaged people in our society, including:

  • People with low incomes
  • People of color
  • Young people
  • People with disabilities
  • Immigrants
  • People in rural communities
  • Lesbian, bisexual, and queer women
  • Transgender, gender non-conforming, and intersex people
  • Survivors of domestic violence, sexual violence, or human trafficking

 

The Impact of Abortion Restrictions

Abortion restrictions and bans pose a threat to the health of all pregnant people by denying and delaying care, including medically necessary care for people with pregnancy complications.6,7 Research has shown that restrictions on abortion access cause harm to people’s physical and mental health as well as their social and economic well-being.8

Across the U.S., bans enacted or triggered by many states since the Dobbs v. Jackson Women’s Health Organization Supreme Court case (“Dobbs”) are contributing to preventable illness and death from conditions including pregnancy loss (i.e., miscarriage), ectopic pregnancy, or fetal demise.9,10,11 This is largely due to “provider reluctance or refusal to provide care because of abortion restrictions, or limitations from institutions, pharmacies, or regional practice."9,13

Because care for pregnancy loss is equivalent to abortion in terms of protocols, medications, and procedures,14,15,16  state laws limiting abortion impact routine physician practice. Studies show that since the Dobbs decision, over one-third of obstetricians-gynecologists (ob-gyns) nationally and up to 55% in abortion ban states report a decline in their ability to practice medicine in alignment with standards of care.17,18,19, 20 A quarter of ob-gyns report constraints on their ability to manage miscarriages and other pregnancy-related emergencies.19 In one study of physicians in abortion ban states, 60% indicated they considered leaving their state to practice elsewhere,21 while other research found that in Idaho, 35% of obstetrics providers left the state between 2022 and 2024.20,22,23

Physicians also express concerns about the impact of abortion restrictions on their patients. Half of providers in abortion ban states reported patients in their practice have not able to obtain the abortions they sought, compared to 24% of providers in the U.S. overall.24 As of early 2024, over two thirds of ob-gyns nationally and 70% in states with abortion bans or gestational limits on abortion believed that racial and ethnic inequities in maternal health had worsened since the decision.17 These physician perceptions align with data: since the Dobbs decision, restrictive abortion policies have exacerbated maternal health disparities among women of color, particularly Black women, by increasing the risks of maternal morbidity and mortality, worsening access to prenatal and emergency care, and amplifying provider shortages and systemic inequities.25,26 Maternity care deserts (predominantly rural geographic areas where little or no obstetric care exists) have expanded in the years post-Dobbs.27

 

LA County’s Response

Anticipating the overturning of Roe in June 2022, the LA County Board of Supervisors passed a motion to ensure the County would maintain access to quality reproductive health care services for residents and visitors losing abortion access in other states. Subsequently, the state of California enacted new legislative protections for abortion patients, providers, and clinics, and funded a grant program to bolster these protections and promote access, particularly within LA County.

 

Abortion Safe Haven Project

Abortion Safe Haven Project logo

The Los Angeles County Abortion Safe Haven (ASH) Project is a collaborative effort that aims to ensure abortion services are accessible for anyone who needs them in LA County, including visitors from other jurisdictions who travel here to recieve care.

The Abortion Safe Haven Project is comprised of County agencies; nonprofit and academic partners; reproductive health, rights, and justice advocates; and health care providers. ASH has strengthened infrastructure and expanded education and training, community outreach, and practical support (to cover expenses related to seeking medical care, including transportation, lodging, and child care). 

State funding was allocated to ASH in 2023 and distributed via Essential Access Health to diverse organizations, clinics, and the County. The Department of Public Health received funding to train County personnel on abortion facts and resources, specifically to counter misinformation and expedite needed referrals, and has developed a website and educational materials for providers and the public.

Resources and Guides

Health care providers can use the Abortion Safe Haven website to expedite referrals for their patients and clients. 

Abortion Safe Haven Project Website

Resources available are listed below. These embedded links direct to the English version of these documents. To access materials in 11 other languages, please visit the ASH website home page.

For hard copies of materials, including postcards with a QR code for the ASH website, please contact AbortionLAC@ph.lacounty.gov.

 

Education and Training for LA County Health Professionals with free CME

Abortion Safe Haven Project logo

For LA County to truly be a safe haven for abortion rights, medical and public health professionals must have the tools to provide fact-based, timely, and accurate information for our patients and communities. 

The Office of Women’s Health has created a 1.25-hour online training, with free continuing medical education credit, for physicians and other health professionals to understand why abortion access is fundamental to heath and safety and to facilitate providers’ role in making connections to abortion counseling and care in LA County.

To access the webinar and resources for providers, please visit: http://publichealth.lacounty.gov/cme/AbortionFactsResourcesWebinar.

 

References

  1. American College of Obstetricians and Gynecologists (ACOG). Abortion care. ACOG. Accessed July 14, 2025. https://www.acog.org/womens-health/faqs/induced-abortion
  2. Kortsmit K, Nguyen AT, Mandel MG, et al. Abortion surveillance — United States, 2021. MMWR Surveill Summ. 2023;72(9):1-29. doi:10.15585/mmwr.ss7209a1
  3. World Health Organization. Abortion. World Health Organization. Published May 17, 2024. Accessed July 14, 2025. https://www.who.int/news-room/fact-sheets/detail/abortion
  4. Society of Family Planning. #WeCount report: April 2022 through December 2024. Published June 23, 2025. Accessed August 21, 2025. https://societyfp.org/wecount-report-9-december-2024-data/. doi:10.46621/725961gzsnai
  5. SisterSong Women of Color Reproductive Justice Collective. Reproductive Justice. SisterSong. https://www.sistersong.net/reproductive-justice. Accessed November 19, 2025.
  6. Kimport K, Kaller S. Not actively dying: An inductive categorization of obstetric cases negatively affected by post-Dobbs abortion bans. Contraception. 2025 Jul 25;111043. doi:10.1016/j.contraception.2025.111043.
  7. Reproductive Access Project. Insights: The Impacts of Abortion Bans on Maternal Health. 2025. Accessed October 7, 2025. https://www.reproductiveaccess.org/resource/insights-the-impacts-of-abortion-bans-on-maternal-health/
  8. Foster Green D. UCSF Turnaway Study shows impact of abortion access on well-being. UC San Francisco. Published June 23, 2022. Accessed September 2, 2025. https://www.ucsf.edu/news/2022/06/423161/ucsf-turnaway-study-shows-impact-abortion-access
  9. Kimport K. Abortion after Dobbs: Defendants, denials, and delays. Sci Adv. September 2022. doi:10.1126/sciadv.ade5327
  10. Berglas NF, Barnes JT, Gonzalez Ba E, Peters L, Foster DG. Changes in abortion access, travel, and costs since the implementation of state abortion bans, 2022-2024. Am J Public Health. 2025;():e1-e10. doi:10.2105/AJPH.2025.308191
  11. Grossman D, Joffe C, Kaller S, Kimport K, Kinsey ET, Morris N, White K. Care Post-Roe: Documenting Cases of Poor-Quality Care Since the Dobbs Decision. Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco; 2024. Accessed August 26, 2025. https://sixrepro.org/wp-content/uploads/2023/07/ANSIRH-Care-Post-Roe-Report-9.04.24.pdf
  12. Life of the Mother. ProPublica. Published September 26, 2024. Accessed August 26, 2025. https://www.propublica.org/series/life-of-the-mother
  13. Srinivasulu S. Insights: The Impacts of Abortion Bans on Maternal Health. Reproductive Health Access Project; January 28, 2025. Accessed August 26, 2025. https://www.reproductiveaccess.org/resource/insights-the-impacts-of-abortion-bans-on-maternal-health/
  14. Beaman J, Prifti C, Schwarz EB, Sobota M. Medication to manage abortion and miscarriage. J Gen Intern Med. 2020;35(8):2398-2405. doi:10.1007/s11606-020-05836-9
  15. Ranji U, Salganicoff A, Sobel L. Dobbs-Era Abortion Bans and Restrictions: Early Insights About Implications for Pregnancy Loss. Kaiser Family Foundation; May 2, 2024. Accessed August 26, 2025. https://www.kff.org/womens-health-policy/dobbs-era-abortion-bans-and-restrictions-early-insights-about-implications-for-pregnancy-loss/
  16. Tunçalp O, Gülmezoglu AM, Souza JP. Surgical procedures for evacuating incomplete miscarriage. Cochrane Database Syst Rev. 2010;(9):CD001993. doi:10.1002/14651858.CD001993.pub2
  17. Sabbath EL, McKetchnie SM, Arora KS, Buchbinder M. US obstetrician-gynecologists’ perceived impacts of post–Dobbs v Jackson State abortion bans. JAMA Netw Open. 2024;7(1):e2352109. doi:10.1001/jamanetworkopen.2023.52109
  18. Ranji U,  Salganicoff A, Sobel L. Dobbs-era Abortion Bans and Restrictions: Early Insights about Implications for Pregnancy Loss. Kaiser Family Foundation. May 2, 2024. Accessed August 26, 2025. https://www.kff.org/womens-health-policy/dobbs-era-abortion-bans-and-restrictions-early-insights-about-implications-for-pregnancy-loss/
  19. National Partnership for Women & Families. Dobbs’ Erosion of the Health Care Workforce: Harms to Providers and Patients. NPWF; 2024. Accessed August 26, 2025. https://nationalpartnership.org/wp-content/uploads/dobbs-erosion-health-care-workforce.pdf
  20. Frederiksen B,  Ranji U, Gomez I, and Salganicoff A. A National Survey of OBGYNs’ Experiences After Dobbs. Kaiser Family Foundation. Jun 21, 2023. Accessed August 26, 2025. https://www.kff.org/womens-health-policy/a-national-survey-of-obgyns-experiences-after-dobbs/
  21. UNC Health. Researchers Document Health Provider Impacts from Post-Dobbs Abortion Bans. Published January 2024. Accessed August 26, 2025. https://news.unchealthcare.org/2024/01/researchers-document-health-provider-impacts-from-post-dobbs-abortion-bans/
  22. The American College of Obstetricians and Gynecologists. Issue Brief: Training and Workforce After Dobbs. ACOG; 2024. Accessed August 26, 2025. https://www.acog.org/advocacy/abortion-is-essential/trending-issues/issue-brief-training-and-workforce-after-dobbs
  23. Idaho Coalition for Safe Healthcare. Idaho OB-GYN Exodus Report. Published April 2023. Accessed August 26, 2025. https://idahocoalitionforsafehealthcare.org/obgyn-exodus-report
  24. Staiger B, Bolotnyy V, Borrero S, Rossin-Slater M, Van Parys J, Myers C. Obstetrician and gynecologist physicians’ practice locations before and after the Dobbs decision. JAMA Netw Open. 2025;8(4):e251608. doi:10.1001/jamanetworkopen.2025.1608
  25. Hill L, Rao A, Artiga S, Ranji U. Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them. Kaiser Family Foundation. October 25, 2024. Accessed August 26, 2025. https://www.kff.org/racial-equity-and-health-policy/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/
  26. Hill L, Artiga S, Ranji U, Gomez I, Ndugga N. What are the Implications of the Dobbs Ruling for Racial Disparities? Kaiser Family Foundation. Apr 24, 2024. Accessed August 26, 2025. https://www.kff.org/womens-health-policy/what-are-the-implications-of-the-dobbs-ruling-for-racial-disparities/
  27. March of Dimes. Nowhere to Go: Maternity Care Deserts Across the US. March of Dimes; 2024. Accessed October 7, 2025. https://www.marchofdimes.org/peristats/assets/s3/reports/2024-Maternity-Care-Report.pdf
 

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Table of Contents:

Key Points

Access to Abortion is a Public Health Issue

The Impact of Abortion Restrictions

LA County’s Response

Abortion Safe Haven Project

Resources and Guides

Education and Training for LA County Health Professionals with Free CME

References

 

Author Information:

Susie Baldwin, MD, MPH, FACPM
Medical Director

Erika Martinez Abad, MPH
Staff Analyst

The Office of Women's Health Team

Office of Women’s Health
County of Los Angeles
Department of Public Health


 

AbortionLAC@ph.lacounty.gov

http://publichealth.lacounty.gov/owh


Rx for Prevention, 2025
Published: November 20, 2025