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Money and place: Quantifying the types of obstacles associated with seeking an abortion after 10 weeks' gestation, 2019-2020.
Mackinnon Krems, Jennifer; Grossman, Daniel; Ehrenreich, Katherine; Ralph, Lauren.
Afiliación
  • Mackinnon Krems J; Joint Medical Program, University of California San Francisco and University of California Berkeley, San Francisco and Berkeley, CA, USA. Electronic address: jennifer.mackinnonkrems@ucsf.edu.
  • Grossman D; Advancing New Standards in Reproductive Health, Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, CA, USA.
  • Ehrenreich K; Advancing New Standards in Reproductive Health, Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, CA, USA.
  • Ralph L; Advancing New Standards in Reproductive Health, Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, CA, USA.
Contraception ; 136: 110476, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38679274
ABSTRACT

OBJECTIVES:

Identify factors associated with presenting for abortion after 10 weeks' gestation in a large, geographically diverse sample. STUDY

DESIGN:

From October 2019 to March 2020, we surveyed 1089 patients seeking abortion at seven U.S. facilities. We identified four domains of barriers geographic, financial, logistical/personal, and legislative. Using multivariable logistic regression, we investigated the relationship between each domain and presenting for abortion after 10 weeks' gestation, overall and stratified by state policy landscape.

RESULTS:

One-third of participants reported geographic (33.0%), financial (33.3%), and logistical/personal (31.4%) barriers; fewer (4.8%) reported legislative barriers. One-third (30.8%) traveled over 50 miles to the clinic. One-quarter (25.2%) presented after 10 weeks' gestation. In multivariable analyses, financial barriers (adjusted odds ratio [aOR] = 1.49, 95% confidence interval [CI] = 1.06-2.09), geographic barriers (aOR = 2.05, 95% CI = 1.44-2.90), and difficulty meeting basic expenses (aOR = 1.47, 95% CI = 1.15-1.89) were associated with presenting after 10 weeks' gestation across the seven clinics. Among participants accessing care at clinics in states with supportive abortion policies (n = 178), geographic barriers remained significantly associated with presenting after 10 weeks' gestation.

CONCLUSIONS:

In a large, geographically diverse sample, financial and geographic barriers were associated with presenting after the threshold for medication abortion. In supportive states, the association with geographic barriers persisted. Cost and geographic barriers are increasing as more states restrict abortion post-Dobbs, highlighting the urgent need to expand financial and travel support. IMPLICATIONS People seeking abortion faced barriers before the Dobbs decision. Now, post-Dobbs, restrictions to abortion have only increased, making barriers to care even more threatening. Providing access to financial resources and transportation for people seeking abortion and expanding telehealth medication for abortion is now even more important.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aborto Inducido / Accesibilidad a los Servicios de Salud Límite: Adolescent / Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: Contraception Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aborto Inducido / Accesibilidad a los Servicios de Salud Límite: Adolescent / Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: Contraception Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos