Advertisement

Predictors of delay in each step leading to an abortion

  • Diana G. Foster
    Correspondence
    Corresponding author. UCSF Box 1744, San Francisco, CA 94143-1744, USA. Tel.: +1 415 206 2337.
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA 94110, USA
    Search for articles by this author
  • Rebecca A. Jackson
    Affiliations
    Department of Epidemiology and Biostatistics, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
    Search for articles by this author
  • Kate Cosby
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA 94110, USA
    Search for articles by this author
  • Tracy A. Weitz
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA 94110, USA
    Search for articles by this author
  • Philip D. Darney
    Affiliations
    Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
    Search for articles by this author
  • Eleanor A. Drey
    Affiliations
    Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
    Search for articles by this author

      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.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Strauss L.T.
        • Gamble S.B.
        • Parker W.Y.
        • Cook D.A.
        • Zane S.B.
        • Hamdan S.
        Abortion surveillance ��� United States, 2003.
        MMWR Surveill Summ. 2006; 55: 1-32
        • Bartlett L.A.
        • Zane S.B.
        • Berg C.J.
        Risk factors for legal induced abortion-related mortality in the United States.
        Obstet Gynecol. 2004; 104: 636
        • Henshaw S.K.
        • Finer L.B.
        The accessibility of abortion services in the United States, 2001.
        Perspect Sex Reprod Health. 2003; 35: 16-24
        • Finer L.B.
        • Henshaw S.K.
        Abortion incidence and services in the United States in 2000.
        Perspect Sex Reprod Health. 2003; 35: 6-15
        • Gallup Poll News Service
        Gallup's Pulse of Democracy: abortion.
        ([Accessed April 1, 2007])
        • Weitz T.
        • Jones B.
        Regulating abortion out of existence.
        in: Boston, MA: National Abortion Federation Annual Meeting, April2007
        • Drey E.A.
        • Foster D.G.
        • Jackson R.A.
        • Lee S.J.
        • Cardenas L.H.
        • Darney P.D.
        Risk factors associated with presenting for abortion in the second trimester.
        Obstet Gynecol. 2006; 107: 128-135
        • Finer L.B.
        • Frohwirth L.F.
        • Dauphinee L.A.
        • Singh S.
        • Moore A.M.
        Timing of steps and reasons for delays in obtaining abortions in the United States.
        Contraception. 2006; 74: 334-344