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
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References
- Abortion surveillance ��� United States, 2003.MMWR Surveill Summ. 2006; 55: 1-32
- Risk factors for legal induced abortion-related mortality in the United States.Obstet Gynecol. 2004; 104: 636
- The accessibility of abortion services in the United States, 2001.Perspect Sex Reprod Health. 2003; 35: 16-24
- Abortion incidence and services in the United States in 2000.Perspect Sex Reprod Health. 2003; 35: 6-15
- Gallup's Pulse of Democracy: abortion.([Accessed April 1, 2007])
- Regulating abortion out of existence.in: Boston, MA: National Abortion Federation Annual Meeting, April2007
- Risk factors associated with presenting for abortion in the second trimester.Obstet Gynecol. 2006; 107: 128-135
- Timing of steps and reasons for delays in obtaining abortions in the United States.Contraception. 2006; 74: 334-344
Article Info
Publication History
Published online: February 14, 2008
Accepted:
October 16,
2007
Received:
June 18,
2007
Footnotes
���This study was funded by the David and Lucile Packard Foundation.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
