P4| Volume 94, ISSUE 4, P393-394, October 2016

Predictors of pregnancy options counseling and abortion referrals or dissuasion among United States primary care physicians: results from a national survey

      Objectives: Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy by providing high-quality options counseling and referrals. However, little is known about options counseling, abortion referrals, and abortion dissuasion among US PCPs.
      Methods: We surveyed a nationally representative sample of 3000 PCPs with specialties in family, general, or internal medicine randomly selected from the American Medical Association's Physician Masterfile in 2014–2015. Analyses were weighted to account for sampling design and differential nonresponse. Predictors of routine options counseling (offering to discuss abortion, adoption and parenting), abortion referrals and abortion dissuasion were assessed through multivariable logistic regression.
      Results: Training breakdown among respondents was 50.9% family medicine, 44.5% internal medicine and 4.7% other (response rate=29%). Family physicians were more likely to provide routine options counseling than others (OR=2.0, p<0.01). Factors associated with routine abortion referrals were more years in practice (OR=1.03 per year, p<0.05), being female versus male (OR=2.13, p<0.01) and practicing in a hospital versus private primary care/multispecialty setting (OR=3.17, p<0.05). Lower odds of routine abortion referrals were seen among physicians in practices with Catholic and other religious affiliations versus no affiliation (OR=0.27, p<0.01; 0.36, p<0.05). Personal Christian religious affiliation among those who attend services twice/month or more versus no religious affiliation was associated with lower odds of options counseling (OR=0.47, p<0.05) and abortion referrals (OR=0.31, p<0.01) and higher odds of attempting to dissuade women from abortion (OR=4.17, p<0.01).
      Conclusions: Findings suggest intervention areas to support fuller integration of options counseling and abortion referrals into primary care by targeting PCPs who are the least likely to provide these services.