Erin Wingo1, Lauren Ralph2, Shelly Kaller2, M Antonia Biggs2. 1. Department of Family and Community Medicine, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA, 94110, USA. Electronic address: erin.wingo@ucsf.edu. 2. Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1330 Broadway Suite 1100, Oakland, CA 94612, USA.
Abstract
OBJECTIVE: To explore abortion method preference, interpersonal and cultural factors associated with preference, and whether, among people with a preference for medication abortion, those presenting past 10 weeks gestation had experienced more obstacles to care. METHODS: In 2019, we invited people aged 15-45 years presenting to four U.S. abortion clinics to complete a self-administered, anonymous iPad survey prior to seeing the healthcare provider. Questions focused on their pregnancy, including self-reported gestational age and experiences accessing abortion care, including abortion method preference. We used multivariate logistic regression to assess associations between worry about perceived pregnancy-related stigma or abortion-related health myths and abortion method preference. RESULTS: The majority (784 [77%]) of those approached (1092) initiated the survey and 712 responded to the preference question. Most (597 [84%]) preferred a method: 246 (41%) preferred medication abortion and 351 (59%) an in-clinic procedure. About one-third (110 [32%]) of those preferring medication abortion exceeded 10 weeks gestation and 83% (n=91) had experienced delay-causing obstacles to care. In multivariate analyses, we found a greater odds of preference for medication abortion over in-clinic procedure among those very worried about people's reaction to the pregnancy (aOR 1.95, 95% CI 1.16-3.28), judgment from God or religion (aOR 1.93, 95% CI 1.17-3.19) and abortion affecting mental health (aOR 2.51, 95% CI 1.45-4.34) or ability to get pregnant later (aOR 1.80, 95% CI: 1.09-2.97). CONCLUSIONS: Many people seeking abortion have a method preference; delayed presentation to care may impede ability to obtain desired method. Pregnancy-related stigma and misinformation are associated with preference for medication abortion.
OBJECTIVE: To explore abortion method preference, interpersonal and cultural factors associated with preference, and whether, among people with a preference for medication abortion, those presenting past 10 weeks gestation had experienced more obstacles to care. METHODS: In 2019, we invited people aged 15-45 years presenting to four U.S. abortion clinics to complete a self-administered, anonymous iPad survey prior to seeing the healthcare provider. Questions focused on their pregnancy, including self-reported gestational age and experiences accessing abortion care, including abortion method preference. We used multivariate logistic regression to assess associations between worry about perceived pregnancy-related stigma or abortion-related health myths and abortion method preference. RESULTS: The majority (784 [77%]) of those approached (1092) initiated the survey and 712 responded to the preference question. Most (597 [84%]) preferred a method: 246 (41%) preferred medication abortion and 351 (59%) an in-clinic procedure. About one-third (110 [32%]) of those preferring medication abortion exceeded 10 weeks gestation and 83% (n=91) had experienced delay-causing obstacles to care. In multivariate analyses, we found a greater odds of preference for medication abortion over in-clinic procedure among those very worried about people's reaction to the pregnancy (aOR 1.95, 95% CI 1.16-3.28), judgment from God or religion (aOR 1.93, 95% CI 1.17-3.19) and abortion affecting mental health (aOR 2.51, 95% CI 1.45-4.34) or ability to get pregnant later (aOR 1.80, 95% CI: 1.09-2.97). CONCLUSIONS: Many people seeking abortion have a method preference; delayed presentation to care may impede ability to obtain desired method. Pregnancy-related stigma and misinformation are associated with preference for medication abortion.
Authors: Emma Carpenter; Hillary Gyuras; Kristen L Burke; Danielle Czarnecki; Danielle Bessett; Michelle McGowan; Kari White Journal: Contraception Date: 2022-10-11 Impact factor: 3.051