Expanded Access to Postabortion Contraception under Oregon's Reproductive Health Equity Act.

Abstract

We describe the first 24months of expanded family planning services for low-income immigrants under Oregon's Reproductive Health Equity Act. We examined postabortion contraceptive use in rural versus urban locations. We conducted a historical cohort study of abortion services reimbursed under the Reproductive Health Equity Act in the first 2years after its implementation (2018 and 2019). Our primary outcome was shift in contraceptive tier from a less effective method before an abortion to a more effective contraceptive method after an abortion. Our key independent variable was residence in a metropolitan or nonmetropolitan area. We tested the association of nonmetropolitan residence and shift to a tier 1 or tier 2 method after the abortion, controlling for other factors, using logistic regression. Our analysis included 625 abortions from across the state. After an abortion, 68% of women transitioned to a more effective form of contraception. Nonmetropolitan residence was not significantly associated with a shift from no method or a tier 3 method to tier 1 or tier 2 method (adjusted odds ratio, 1.28; 95% confidence interval, 0.81-2.02) compared with metropolitan residence. The program was successful in helping women not wishing pregnancy to transition to a more effective contraceptive method postabortion, regardless of metropolitan location of residence.