Restoring, Protecting, and Expanding Abortion Access in the United States: Seeking Consensus Through the Delphi Method.

INTRODUCTION

The Dobbs v. Jackson Women's Health Organization United States (US) Supreme Court decision exacerbated inequitable access to abortion rights in the United States. This study aimed to determine the degree of agreement on which strategies should be prioritized to restore, protect, and expand abortion access.

METHODOLOGY: From July to December 2023, we convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement ≥ 67%) on recommended actions. Using feedback from three survey rounds, and input from an Expert Advisory Group (N = 10), we iteratively refined the statements and recommendations.

RESULTS

The expert panel (N = 85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, policymakers, and clinical experts in states with protected, mixed, or restricted abortion policies as classified by the Guttmacher Institute at the time of each survey round (July, September, and November 2023). Key recommendations included incorporating abortion into primary care, establishing referral chains for individuals seeking abortion, and combatting gerrymandering and voter suppression.

DISCUSSION: Consensus was reached on actionable priorities to address inequitable access to abortion in varying policy environments, while also highlighting areas where strategic discussions are needed.