title: Changes in abortion provider practices in response to the Partial-Birth Abortion Ban Act of 2003.
abstract: BACKGROUND
  The April 2007 Supreme Court Gonzalez v. Gonzalez v. Carhart decision upheld the Partial-Birth Abortion Ban Act of 2003. We conducted a pilot study that measured the impact of the ban in one state with a diverse pool of second-trimester abortion providers.
  
  
  METHODS
  A survey was administered via telephone to key informants at each facility in Massachusetts where second-trimester abortions are performed in order to assess clinical and administrative changes following the Supreme Court decision.
  
  
  RESULTS
  Five hospital-based practices introduced injections to induce fetal demise prior to dilation and evacuation for later second-trimester abortions. One site stopped providing dilation and evacuation abortions in the absence of fetal or maternal indications, and another significantly decreased its volume of procedures. Training opportunities were decreased, and costs at three facilities increased.
  
  
  CONCLUSIONS
  The Partial-Birth Abortion Ban Act of 2003 resulted in a range of practice changes in Massachusetts, particularly in hospitals. These changes reflect adherence to legal and policy mandates and not the availability of new scientific evidence. Further study to assess the impact of the ban in states with fewer providers is warranted.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Haddad
authors.forename: Susan
authors.initials: S
authors.lastname: Yanow
authors.forename: Laurent
authors.initials: L
authors.lastname: Delli-Bovi
authors.forename: Kate
authors.initials: K
authors.lastname: Cosby
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Weitz