Women Seeking Abortion Services Research Articles

Between a Rock and a Hard Place: Abortion, Catholicism, the Populist Right and Public Health Threats in Poland

This article analyzes how and why a near-total abortion ban was recently secured by a populist ruling party with support from Catholic Church leaders and lay groups following earlier passage of one of the most restrictive abortion laws in Europe. The paper further examines the public health threats posed by these measures, which have long been under-researched. These policy shifts are situated within the deeply embedded context of Poland’s abortion conflict and a setting that has long been challenging for reproductive health. The 1993 ban led to the resurgence of clandestine abortions, a near-total privatization of abortion services, and more women seeking abortion services overseas. In late 2020, the exemption for severe fetal anomalies that made up 97% of all legal abortion cases in prior years was eliminated. Neither ban has significantly reduced the number of women obtaining abortions, nor have they increased birth rates as anticipated by proponents who championed traditional family values that they equated with Catholicism and Polish national identity. The new blanket ban on abortion constitutes a health risk and a punitive measure achieved via a judgement of the Constitutional Tribunal stacked with loyalists by the ruling party. It did not reflect popular will, although societal attitudes on abortion are markedly less permissive than in much of Europe. Although the populist and religious right have realized their long-held goal of further restricting, if not eliminating, women’s access to abortion services, compelling criticisms have been raised about how this move compromises women’s health and autonomy. Ironically, the realization of this goal, which many Poles view as unduly extreme, may also undermine long-term support for both the political right and the Church. The wisdom of their move was widely questioned, sparked the largest protests since the end of Communist rule, and drew international criticism. It proved a polarizing action that alienated many young adults and may have accentuated a secularizing shift. Women and their partners are finding new ways to navigate many public health threats by increasingly traveling beyond Poland for safe abortion care and resorting to newly available medication abortion methods.

Postabortion Family Planning Utilization and Associated Factors among Women seeking Abortion Services: A Cross-Sectional Study

Ethiopia is a country which suffers with one of the highest levels of unintended pregnancies and unsafe abortion practices. The aim of this study was to assess the utilization of post-abortion family planning and associated factors among women seeking abortion services in Asella town health facilities. A facility based cross-sectional study design was conducted among women who came for abortion services from July 15 to October 15, 2019. Two hundred seventy-six participants were included using a systematic random sampling technique. Both descriptive and logistic regression analysis were conducted. In multivariate analysis, variables which had a p-value < 0.05 was considered as significantly associated with the outcome variable. Postabortion family planning utilization among study participants was 146 (53.7%) (95% CI=47.4, 59.2). Formal education (AOR=4.45: 95% CI: (1.18, 16.74), previous history of abortion (AOR=0.35; 95% CI: (0.14, 0.85), positive attitude to towards family planning (AOR=2.62; 95% CI: (1.09, 6.27), counseled on postabortion family planning utilization (AOR=3.12; 95% CI: (1.30, 7.51) were significantly associated with post abortion family planning utilization. In this study, nearly fifty percent of the respondents did not utilize Postabortion Family Planning (PAFP). Educational status, history of pervious abortion, decision when to have a child, attitude toward PAFP utilization and counseling about PAFP were significantly associated with post-abortion family planning use. The health care providers who give abortion service should give counseling for all women who get abortion service. More accents should be given to misperception of PAFP to change the negative attitude of utilization of PAFP.

“They talked to me rudely”. Women perspectives on quality of post-abortion care in public health facilities in Kenya

BackgroundAccess to safe abortion is legally restricted in Kenya. Therefore, majority women seeking abortion services in such restrictive contexts resort to unsafe methods and procedures that result in complications that often require treatment in health facilities. Most women with abortion-related complications end up in public health facilities. Nevertheless, evidence is limited on the quality of care provided to patients with abortion complications in public health facilities in Kenya.MethodsData for this paper are drawn from a qualitative study that included interviews with 66 women who received post-abortion care in a sample of primary, secondary and tertiary public health facilities in Kenya between November 2018 and February 2019. The interviews focused on mechanisms of decision-making while seeking post-abortion care services, care pathways within facilities, and perceptions of patients on quality of care received including respect, privacy, confidentiality, communication and stigma.FindingsThe participants’ perceptions of the quality of care were characterized as either “bad care” or “good care”, with the good care focusing on interpersonal aspects such as friendliness, respect, empathy, short waiting time before receiving services, as well as the physical or functional aspects of care such as resolution of morbidity and absence of death. Majority of participants initially reported that they received “good care” because they left the facility with their medical problem resolved. However, when probed, about half of them reported delays in receiving care despite their condition being an emergency (i.e., severe bleeding and pain). Participants also reported instances of abuse (verbal and sexual) or absence of privacy during care and inadequate involvement in decisions around the nature and type of care they received. Our findings also suggest that healthcare providers treated patients differently based on their attributes (spontaneous versus induced abortion, single versus married, young versus older). For instance, women who experienced miscarriages reported supportive care whereas women suspected to have induced their abortions felt stigmatized.ConclusionThese findings have far reaching implications on efforts to improve uptake of post-abortion care, care seeking behaviors and on how to assess quality of abortion care. There should be emphasis on interventions meant to enhance processes and structural indicators of post-abortion care services meant to improve patients’ experiences throughout the care process. Moreover, more efforts are needed to advance the tools and approaches for assessing women experiences during post-abortion care beyond just the overriding clinical outcomes of care.

A profile of abortion in a tertiary care centre: An observational study

The recent years have seen rise in unintended pregnancy which includes unwanted and mistimed pregnancy. Despite the conducive environment of legal abortion in India through MTP Act, many women resort to unsafe methods of abortion. In India, estimated abortions in 2015 were 15.6 million. The overall rate of abortion was estimated to be 4.8%, among which 67.1% of abortions were classified to be unsafe. Thus, the aim of the study is to analyze the demographic profile of patients, reason for seeking abortion and evaluation of significant adverse outcome and management. This was a hospital-based observation study carried out in the department of OBG in MMC&RI, Mysuru during the period January 2019 to December 2020. 100 women seeking MTP and 100 women presenting to hospital for help following the consumption of over the counter pills were included in the study. : 100 women with self-consumption of pills presented to hospital with complaints of heavy bleeding (35%), spotting PV (22%) and pain abdomen (15%). Most were married, belonging to lower socioeconomic status with age of 21-25 years (42%), followed by 26 – 30 years (22%). In 100 women seeking MTP, congenital fetal anomalies (51%) was the main indication, followed by contraception failure (36%). In comparison to the women seeking abortion services under medical supervision, the complication rates were higher in unsupervised group. This included retained products of conception (25%), moderate anemia (12%), severe anemia (7%), shock (3%), sepsis (4%) requiring surgical evacuation (51%), medical management (46%), anemia correction (17%), ICU admission (7%) and emergency laparotomy (3%). The cornerstone is motivation and encouragement of women to adapt family planning services to reduce unintended pregnancy. For women needing these services, accessibility and comprehensive education regarding unsafe abortion is needed. Legislation and strict policy is required for the use of MTP pills, so as to reduce the sales without prescription.

Catalyst for change: Lessons learned from overcoming barriers to providing safe abortion care in Médecins Sans Frontières projects.

Despite instituting a policy in 2004, Médecins Sans Frontières (MSF) continuously struggled to routinely provide safe abortion care (SAC). In 2016, the organization launched an initiative aimed at increasing availability of SAC in MSF projects and increasing understanding of abortion-related dynamics in humanitarian settings. From March 2017 to April 2018, MSF staff conducted support visits to 10 projects in a country in sub-Saharan Africa. Each visit followed a systematic approach with six key components and related tools that were later shared with teams worldwide. Data regarding women seeking abortion services and related outcomes were collected and analyzed retrospectively. From Q1 2017 through Q4 2019, SAC provision increased significantly in all 10 projects, rising from three to 759 safe abortions per quarter. Teams received 3831 patients seeking SAC and provided 3640 first and second trimester abortions, over 99% via medication methods. The overall complication rate was 4.29% and 0.3% for severe, life-threatening complications. No major security incidents were reported. MSF provision of SAC worldwide increased from 781 in 2016 (the year before this initiative began) to 21,546 in 2019. Implementation of SAC in humanitarian settings-even those with significant legal restrictions-is possible and necessary. Both first and second trimester medication abortion can be safely and effectively provided through both home- and facility-based models of care. Programmatic data provide valuable insights into abortion-related dynamics which must shape operational decision-making. Addressing internal barriers and providing direct field support were key to stimulating organizational cultural change.

Repeat-induced abortion and associated factors among reproductive-age women seeking abortion services in South Ethiopia.

Introduction:Despite the advances in modern health care, maternal morbidity and mortality remain major problems in Ethiopia. Repeat-induced abortion is an indispensable contributor to this problem. Even though there are adverse effects on health, a significant proportion of Ethiopian women procure more than one abortion during their reproductive lifetime. This study aimed to determine the prevalence and associated factors of repeat-induced abortion in South Ethiopia, in 2020.Methods:An institution-based cross-sectional study design and a systematic random sampling technique were used to collect data from 410 samples of women. Data were collected using pre-tested and semi-structured interviewer-administered questionnaires. The data were coded and entered into EpiData version 4.6.2.0 before being exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Variables with a p-value of less than 0.05 in binary logistic regressions were exported into multivariate logistic regression analysis. Finally, variables with a p-value of less than 0.05 in the multivariate logistic regression analysis were used to declare statistical significance.Result:The prevalence of repeat-induced abortion was found to be 35.4% (95% confidence interval = 30.7–40). Not facing a complication in prior abortion care, having more than two partners in the last 12 preceding months, perceiving abortion procedure as non-painful, having a sexual debut before the age of 18 years, and consuming alcohol have higher odds of repeat-induced abortion when compared with their counterparts.Conclusion:The prevalence of repeat-induced abortion in Hawassa city is high compared to studies conducted in other parts of Ethiopia. Not facing complications during previous abortion care, perceiving the abortion procedure as non-painful, alcohol consumption, having multiple sexual partners, and having a sexual debut before the age of 18 years are found to increase the chance of repeat-induced abortion.

Contraceptive values and preferences of pregnant women, postpartum women, women seeking emergency contraceptives, and women seeking abortion services: A systematic review

ObjectiveWe sought to systematically review the literature on contraceptive values and preferences of pregnant women, postpartum women, women seeking emergency contraception, and women seeking abortion services, globally. Study designWe searched ten electronic databases for articles from January 1, 2005 through July 27, 2020 regarding users’ values and preferences for contraception. Results were divided into four sub-groups. ResultsTwenty-three studies from 10 countries met the inclusion criteria. Values and preferences across all four sub-groups were influenced by method effectiveness, access, availability, convenience, cost, side effects, previous experience, partner approval, and societal norms. Similarities and differences were evident across sub-groups, especially concerning contraceptive benefits and side effects. No contraceptive method had all the features users deemed important. Many studies emphasized values and preferences surrounding long-acting reversible contraception (LARC), including convenience of accessing LARCs and concerns about side effect profiles. DiscussionIndividuals must have access to a full range of safe and effective modern contraceptive options, allowing people to make decisions based on evolving contraceptive preferences over time. Future contraception guideline development, policy, and programmatic implementation should continue considering the added influence of these specific reproductive experiences on contraceptive values and preferences of users to improve access, counseling, and method choice.

Running an obstacle-course: a qualitative study of women’s experiences with abortion-seeking in Tamil Nadu, India

Irrespective of the legal status of abortion, access to abortion services for women is fraught with numerous challenges across the world. A recent study in India found that most women who had an abortion sought care outside an authorised facility or from a less qualified provider. An analysis of women’s experiences in seeking abortion services would provide a better understanding of the underlying reasons. This paper is based on a qualitative study of the experiences of 16 married women from rural Tamil Nadu, India. The in-depth interviews focused on their pregnancy and childbirth experiences and access to abortion services. The study highlights the obstacle course that women seeking to terminate an unwanted pregnancy have to traverse. Many women were not aware of the legal status of abortion, and frontline workers discouraged them and gave misleading information. The pathways to seeking an abortion were more complex for women from marginalised communities. Providers were judgemental and used delaying tactics or denied abortion services. For the less privileged women, abortion services from government health facilities were conditional on the acceptance of female sterilisation. The providers’ attitudes in government and private health facilities were disrespectful of the women seeking abortion services. To uphold the reproductive and human rights of women who seek abortion services, we need accessible and publicly funded health care services that respect the dignity of all women, are empathetic and uphold women’s right to safe abortion services.

Repeat abortion and associated factors among women seeking abortion services in northwestern China: a cross-sectional study

BackgroundRepeat abortion is a significant public health problem in China. International knowledge about repeat abortion and its associated factors in Chinese women is scarce. This study aimed to analyze the prevalence of repeat abortion among women seeking abortion services with unintended pregnancies in northwestern China and to identify factors associated with the repeat abortion from both two perspectives of abortion seekers themselves and their sexual partners.MethodsThis cross-sectional survey was conducted from May 1st to May 31st, 2020, in 90 medical institutions in Xi’an, the largest city in northwestern China. All women seeking abortions within the first 12 weeks of pregnancy were invited to participate in this survey; however, only those abortion seekers with unintended pregnancies were extracted and included in this study. Pearson’s chi-squared tests, Kolmogorov-Smirnov tests, and binary logistic regression analysis were performed.ResultsOf 3397 abortion seekers, 56.6% (1924) were undergoing repeat abortions. Participants who were older than 30 years (OR: 1.37, 95% CI: 1.08–1.73 for 31–35 years; 1.82, 1.29–2.57 for ≥36 years), received a low-level education (1.86, 1.42–2.43 for ≤senior high school; 1.46, 1.17–1.83 for junior college), were jobless (2.46, 1.18–5.13), had one child (1.54, 1.10–2.17), had a general (1.60, 1.28–1.98) or no (2.51, 2.02–3.11) cognition of possible adverse health effects of having abortions, and had used contraception at the time of conception, i.e., condoms (1.33, 1.09–1.61), withdrawal (1.43, 1.12–1.84), and emergency measures (1.48, 1.09–1.99) were more likely to undergo a repeat abortion. Besides, participants whose sexual partners were older than 30 years (1.33, 1.06–1.68 for 31–35 years; 2.13, 1.56–2.91 for ≥36 years), attained a low-level education (1.66, 1.28–2.15 for ≤senior high school; 1.38, 1.10–1.74 for junior college), received a high-level monthly income (1.34, 1.08–1.65 for ≥6001 Yuan), and had a weak or very weak willingness to use contraception (6.84, 2.42–19.33) were more likely to have a repeat abortion.ConclusionsThe study findings highlight the problem of repeat abortion in China and suggest the need for government and civil society to increase efforts to reduce the risks of unintended pregnancy and repeat abortion in China. One approach may be to offer better access to reproductive health and contraception knowledge to women and their sexual partners and to promote their correct, consistent, and effective contraception practice.

Impact of the COVID-19 pandemic on sexual and reproductive health among women with induced abortion

The coronavirus disease (COVID-19) has already been declared a global pandemic. To our knowledge, there is very little information regarding the effects of COVID-19 on women seeking reproductive health services, specifically abortion. This study was aimed to assess the impact of the COVID-19 pandemic on reproductive and sexual health among women seeking abortion services. We conducted a series of preliminary analyses using data collected from ten maternal and child health hospitals of seven provinces in China before and during the COVID-19 lockdown. The present study showed that a significant decrease was observed in the frequency of sexual intercourse during the COVID-19 pandemic. Moreover, a significant increase in contraceptive use including condom, rhythm method and coitus interruptus whereas a decrease in choosing oral contraceptives were observed during the COVID-19 pandemic. In addition, the pandemic was associated with increased intention of seeking induced abortion due to social factors. Future research should look into the long-term impact of the COVID-19 pandemic on sexual and reproductive health.

Family planning practices and prehospital care received by women seeking abortion services in a tertiary care hospital

Background: The study was carried out in the department of Gynaecology and Obstetrics at RG Kar Medical college and Hospital, among 114 attendees seeking induced or spontaneous abortion. The aim of the study was to assess their socio demographic characteristics, elicit their family planning knowledge, practices and prehospital care received by them before coming to this institute.Methods: An observational descriptive cross-sectional study was carried out using a predesigned, pretested schedule using systemic random sampling technique among women seeking abortion services at a tertiary care centre.Results: Out of the 114 interviewees, 53 (46.5%) underwent induced abortion and rest had spontaneous abortion. Statistically significant difference was found between the mean age of induced and spontaneous abortion seekers. Majority i.e. 28 (52.8%) of induced abortion seekers first sought help at illegal abortion service providers. Statistically significant difference was found in duration of marriage, gravidity and number of living children between induced and spontaneous abortion candidates. Contraceptive knowledge and practice were found to be higher among induced abortion seekers.Conclusions: This study clearly shows the need to focus on unmet need for family planning services including safe abortion services at pre-tertiary hospital level. The Government needs to stop advertisement and sale of over the counter abortifacients which is proving to be a menace to women’s health.

Clinician Perspectives on Ethics and COVID-19: Minding the Gap in Sexual and Reproductive Health.

Clinician Perspectives on Ethics and COVID-19: Minding the Gap in Sexual and Reproductive Health.

Family planning practices of women working in the Cambodian garment industry: a qualitative study

BackgroundWomen working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.MethodsWe conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 min and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.ResultsWe interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children.ConclusionThis research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.

Early termination of pregnancy: differences in gestational age estimation using last menstrual period and ultrasound in Mexico

BackgroundGestational age estimation is key to the provision of abortion, to ensure safety and successful termination of pregnancy. We compared gestational age based on reported last menstrual period and ultrasonography among a large sample of women in Mexico City’s public first trimester abortion program, Interrupcion Legal de Embarazo (ILE).MethodsWe conducted a retrospective study of 43,219 clinical records of women seeking abortion services in the public abortion program from 2007 to 2015. We extracted gestational age estimates in days based on last menstrual period and ultrasonography. We calculated the proportion of under- and over-estimation of gestational age based on last menstrual period versus ultrasonography. We compared overall differences in estimates and focused on discrepancies at two relevant cut-offs points (70 days for medication abortion eligibility and 90 days for ILE program eligibility).ResultsOn average, ultrasonography estimation was nearly 1 (− 0.97) days less than the last menstrual period estimation (SD = 13.9), indicating women tended to overestimate the duration of their pregnancy based on recall of date of last menstrual period. Overall, 51.4% of women overestimated and 38.5% underestimated their gestations based on last menstrual period. Using a 70-day limit, 93.8% of women who were eligible for medication abortion based on ultrasonography would have been correctly classified using last menstrual period estimation alone. Using the 90-day limit for ILE program eligibility, 96.0% would have been eligible for first trimester abortion based on last menstrual period estimation alone.ConclusionsThe majority of women can estimate gestational age using last menstrual period date. Where available, ultrasonography can be used, but it should not be a barrier to providing care.

Texas women\u2019s decisions and experiences regarding self-managed abortion

BackgroundPrior research has shown that a small proportion of U.S. women attempt to self-manage their abortion. The objective of this study is to describe Texas women’s motivations for and experiences with attempts to self-manage an abortion. The objective of this study is to describe Texas women’s motivations for and experiences with attempts to self-manage an abortion.MethodsWe report results from two data sources: two waves of surveys with women seeking abortion services at Texas facilities in 2012 and 2014 and qualitative interviews with women who reported attempting to self-manage their abortion while living in Texas at some time between 2009 and 2014. We report the prevalence of attempted self-managed abortion for the current pregnancy among survey respondents, and describe interview participants’ decision-making and experiences with abortion self-management.Results6.9% (95% CI 5.2–9.0%) of abortion clients (n = 721) reported they had tried to end their current pregnancy on their own before coming to the clinic for an abortion. Interview participants (n = 18) described multiple reasons for their decision to attempt to self-manage abortion. No single reason was enough for any participant to consider self-managing their abortion; however, poverty intersected with and layered upon other obstacles to leave them feeling they had no other option. Ten interview participants reported having a complete abortion after taking medications, most of which was identified as misoprostol. None of the six women who used home remedies alone reported having a successful abortion; many described using these methods for several days or weeks which ultimately did not work, resulting in delays for some, greater distress, and higher costs.ConclusionThese findings point to a need to ensure that women who may consider self-managed abortion have accurate information about effective methods, what to expect in the process, and where to go for questions and follow-up care. There is increasing evidence that given accurate information and access to clinical consultation, self-managed abortion is as safe as clinic-based abortion care and that many women find it acceptable, while others may prefer to use clinic-based abortion care.

Medication Abortion? No Need for Narcotics.

For many of the hundreds of thousands of U.S. women seeking abortion services every year, oral mifepristone followed by a dose of misoprostol is

Experience obtaining legal abortion in Uruguay: knowledge, attitudes, and stigma among abortion clients

BackgroundThe abortion law in Uruguay changed in 2012 to allow first trimester abortion on request. Implementation of the law in Uruguay has been lauded, but barriers to care, including abortion stigma, remain. This study aimed to assess women’s experiences seeking abortion services and related attitudes and knowledge following implementation of the law in Uruguay.MethodsWe interviewed 207 eligible women seeking abortion services at a high-volume public hospital in Montevideo in 2014. We generated univariate frequencies to describe women’s experiences in care. We conducted regression analysis to examine variations in experiences of stigma by women’s age and number of abortions.ResultsMost of the women felt that abortion was a right, were satisfied with the services they received, and agreed with the abortion law. However, 70% found the five-day waiting period unnecessary. Women experienced greater self-judgement than worries about being judged by others. Younger women in the sample (ages 18–21) reported being more worried about judgment than women 22 years or older (1.02 vs. 0.71 on the ILAS sub-scale). One quarter of participants reported feeling judged while obtaining services. Women with more than one abortion had nearly three times the odds of reporting feeling judged.ConclusionsThese findings highlight the need to address abortion stigma even after the law is changed. Some considerations from Uruguay that may be relevant to other jurisdictions reforming abortion laws include: the need for strategies to reduce judgmental behavior from staff and clinicians towards women seeking abortions, including training in counseling skills and empathic communication; addressing stigmatizing attitudes about abortion through community outreach or communications campaigns; mitigating the potential stigma that may be perpetuated through policies to prevent “repeat” abortions; ensuring that younger women and those with more than one abortion feel welcome and are not mistreated during care; and assessing the necessity of a waiting period. The rapid implementation of legal, voluntary abortion services in Uruguay can serve in many ways as an exemplar, and these findings may inform the process of abortion law reform in other countries.

Abortion as a Contested Right in Occupied Palestine

Abortion as a Contested Right in Occupied Palestine

\u201cIt\u2019s something that marks you\u201d: Abortion stigma after decriminalization in Uruguay

BackgroundAbortion stigma is experienced by women seeking abortion services and by abortion providers in a range of legal contexts, including Uruguay, where abortion was decriminalized up to 12 weeks gestation in 2012. This paper analyzes opinions and attitudes of both abortion clients and health professionals approximately two years following decriminalization and assesses how abortion stigma manifests among these individuals and in institutions that provide care.MethodsIn 2014, we conducted twenty in-depth, semi-structured interviews with abortion clients (n = 10) and health care professionals (n = 10) in public and private facilities across Uruguay’s health system. Interviews were recorded, transcribed, and then coded for thematic analysis.ResultsWe find that both clients and health professionals express widespread satisfaction with the implementation of the new law. However, there exist critical points in the service where stigmatizing ideas and attitudes continue to be reproduced, such as the required five-day waiting period and in interactions with hospital staff who do not support access to the service. We also document the prevalence of stigmatizing ideas around abortion that continue to circulate outside the clinical setting.ConclusionDespite the benefits of decriminalization, abortion clients and health professionals still experience abortion stigma.

The Relationship Between Partner Violence and Number of Abortions in a National Sample of Abortion Patients.

The purpose of the study was to examine the association between women's experience of two types (sexual and physical) of intimate partner violence (IPV) and number of previous abortions among a national sample of 4,586 abortion patients between the ages of 13 and above 38 years in the United States. Using data from the nationally representative Abortion Patients Survey 2008, χ2 tests were conducted to examine the bivariate associations between all independent and dependent variables. Prevalence ratios were calculated to determine the association between IPV, physical and sexual, and number of abortions, controlling for whether the coconceiving partner knew about the pregnancy and the abortion, and demographic factors including age, education, income, poverty rate, race, and type of union. Results indicate that approximately 51% of the sample of women seeking abortion services had never gotten an abortion before. Reports of IPV were low among this sample-5.6% reported physical violence and 2.4% reported sexual violence, while 82.3% of the coconceiving partners knew about the abortion, and 87.1% knew about the pregnancy. Prevalence ratios revealed that physical violence was positively associated with number of abortions (PR = 1.31, p < .001), but sexual violence was negatively associated with number of abortions (PR = 0.74, p < .05) when all control variables were accounted for. Findings suggesting that physical and sexual violence are differentially associated with a history of multiple abortions were unexpected and suggest the need for additional research in this area. Implications for practice, policy, and directions for future research are discussed.