Predictors of delay in each step leading to an abortion☆
Received 18 June 2007; accepted 16 October 2007. published online 14 February 2008.
Abstract
Background
Approximately 1 out of 10 abortions in the United States occurs in the second trimester of pregnancy. This study uses survival analysis to identify the factors which delay each step of the process of obtaining an abortion.
Study Design
This is a secondary data analysis of a cross-sectional study investigating a sample of 398 women who presented for elective abortion at an urban hospital. Respondents completed a survey using an audio-assisted self-interviewing program and provided a timeline for their process of obtaining an abortion.
Results
In our analysis, we divided the abortion process into three steps ending in three distinct events (first pregnancy test, calling a clinic, getting an abortion). Factors associated with delay during the first step include obesity [hazard ratio (HR) 0.8, 95% CI 0.6–1.0], abuse of drugs or alcohol (HR 0.7, 95% CI 0.6–1.0), prior second-trimester abortion (HR 0.6, 95% CI 0.4–0.8) and being unsure of last menstrual period (HR 0.6, 95% CI 0.4–0.7) and emotional factors such as being in denial (HR 0.8, 95% CI 0.6–1.0) and fear of abortion (HR 0.7, 95% CI 0.5–1.0).
Conclusion
This study identified key factors associated with delay in obtaining abortion care. Interventions which seek to address these factors, especially those factors associated with later pregnancy suspicion and testing, may reduce abortion delay and facilitate women obtaining their abortions when medical risk and overall cost are lower.
aAdvancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA 94110, USA
bDepartment of Epidemiology and Biostatistics, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
cDepartment of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
Corresponding author. UCSF Box 1744, San Francisco, CA 94143-1744, USA. Tel.: +1 415 206 2337.
☆ This study was funded by the David and Lucile Packard Foundation.
ABSTRACT