Delays in request for pregnancy termination: comparison of patients in the first and second trimesters
Received 16 September 2009; received in revised form 16 December 2009; accepted 27 December 2009. published online 11 February 2010.
Abstract
Background
Despite the availability of first trimester abortion services in urban settings, many women request abortion in the second trimester. We identified protective and risk factors associated with women who delay requesting abortions until the second trimester.
Study Design
The study was a cross-sectional survey of 247 patients requesting surgical abortion at an urban family planning clinic. Survey and medical records data were analyzed for associations between 18 risk factors and incidence of second trimester request.
Results
Thirty-two percent of subjects presented in the second trimester. Chi-square analyses revealed that first trimester participants were more often employed (p<.0001), privately insured (p=.01), or had previous abortions (p=.04). Second trimester patients were younger (p<.0001), more often primigravid (p=.04), experienced more difficulty financing the procedure (p<.0001) and finding a surgeon (p<.0001), traveled longer distances (p=.005), and more often feared the procedure (p=.03). Using multiple logistic regression, women requesting second trimester abortions were more likely to report: obstacles financing the abortion (OR 2.34, 95% CI 1.28–4.28); traveling long distances (OR 2.88, 95% CI 1.31-6.31); and fear (OR 2.45, 95% CI 1.17–5.17). These women were less often employed outside the home (OR 0.35, 95% CI 0.19–0.64).
Conclusions
Physicians and advocates must strive to reduce abortion costs, increase access to trained surgeons, and allay women's fears of abortion procedures.
aDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
bDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA 94143, USA
cUniversity of Michigan Medical School, Ann Arbor, MI 48109, USA
dDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
ABSTRACT