Increase in 9-1-1 activations for obstetric-related emergencies following the Dobbs decision in the United States

Abstract The US Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision in June 2022 may have preceded a surge in 9-1-1 activations for obstetric-related conditions. We used time-series analysis to examine whether the Dobbs decision corresponded with a proximate increase in obstetric-related 9-1-1 activations among reproductive-aged (15-49 years) female patients using national, monthly data from January 2018 to December 2023. Monthly national counts of obstetric-related emergent 9-1-1 activations with patient contact from January 2018 to December 2023 were retrieved from the National Emergency Medical Services Information System (NEMSIS) dataset. Monthly series of nonobstetric 9-1-1 activations among reproductive-aged female patients and all other 9-1-1 activations served as controls. Analysis was also stratified by 3 state-groups per restrictiveness of state abortion policies (protective, mixed, and restrictive) within the first 3 months post-Dobbs. A binary indicator of June 2022 with 0- to 3-month lags served as the exposure. Results from time-series analysis showed 913 additional 9-1-1 activations for obstetric-related conditions 1 month following the Dobbs decision. States with protective abortion policies accounted for about 50% of the national increase. Findings indicate an immediate surge in obstetric-related 9-1-1 activations following the Dobbs ruling, primarily in states with protective abortion policies.