Comparing Early COVID-19 Abortion Care Innovations in Hospital Versus Nonhospital Clinics: Data From a Nationwide Survey of Abortion Providers [ID: 1370918

Abstract

INTRODUCTION: We examined differences between hospital-affiliated clinics and non-hospital-affiliated (independent of Planned Parenthood) clinics regarding abortion service innovation in response to the early COVID-19 pandemic. METHODS: We analyzed data from the third phase of a longitudinal nationwide survey of abortion providers conducted by the Society of Family Planning (collected August to October 2020). We analyzed adoption of abortion service innovation, comparing hospital-affiliated clinics to non-hospital-affiliated clinics that included adoption of no- or low-test or low-touch practices for medication abortion and first-trimester surgical abortion. RESULTS: Sixty-one clinics completed the survey (30 hospital affiliated, 31 non-hospital affiliated). We found hospital-affiliated clinics were more likely to be in the Northeast and West (P<.01). We found evidence of adoption, but no significant difference between clinic type in changes in gestational limit, changes in Rh testing policy, or adoption or expansion of telehealth services for pre-abortion counseling. Hospital-affiliated clinics were more likely to have reported making any change to abortion services in response to the pandemic (100% versus 87%, P<.04). Hospital-affiliated clinics were also significantly more likely to start/expand telemedicine visits for follow-up visits for medication abortion (odds ratio [OR] 6.63, 95% CI 1.6–26.8) and first-trimester surgical abortion (OR 12.75, 95% CI 3.1–51.9). CONCLUSION: Abortion care changed quickly, regardless of setting, when the stresses of COVID-19 hit the U.S. health care system. System-wide abortion care changes suggest successful information sharing regarding best practices and recommendations in abortion provision, which should continue to be promoted as the pandemic continues.