Barriers to Obtaining Early Medical and Surgical Abortions [189

Abstract

INTRODUCTION: In 2006, 49% of all pregnancies were unintended, and of these, approximately one third ended in abortion. Although the majority of abortions occur at an early gestational age, complications increase as gestational age increases. Few studies have assessed why patients present later for abortion services. The goal of this study was to assess reasons for obtaining abortion at later gestational age and to characterize demographic variables at the time of abortion. METHODS: A survey was distributed to women on the day of a surgical or medical abortion. Participation was voluntary, and responses were deidentified. Bivariate analysis was conducted using Wilcoxon rank-sum and Kruskal-Wallis, and multivariate analysis was used to simultaneously examine significant predictors. The University of Vermont institutional review board and Planned Parenthood approved the protocol. RESULTS: We enrolled 412 respondents with gestational age ranging from 5 to 19 weeks. Eighty-eight percent of the sample was Caucasian, 67% were having a surgical abortion, and 35% had a previous abortion. A majority (66%) said they would have preferred to have their abortion sooner. Forty percent were using contraception at the time of conception, and popular methods included pills (41%) and condoms (39%). Factors significantly associated with abortion at later gestation included financial concerns, pressure from others, lack of transportation, and personal indecision (P<.05). Factors not associated included household income, education level, marital status, and contraceptive use. CONCLUSION AND IMPLICATION: Barriers continue to exist for women seeking abortion services. These factors should continue to be addressed to ensure accessibility at earlier gestational ages.