Objectives: To explore the relationship of patients’ self-identified race/ethnicity with perceived race/ethnicity-based discrimination during abortion care.
Methods: We surveyed English- or Spanish-speaking individuals aged 18-50 within 30 days of surgical abortion at five Northeastern US reproductive health clinics from June 2020 to February 2021. Participants completed online surveys including race/ethnicity-based discrimination self-assessments measured by the 7-item Discrimination in Medical Settings scale (DMS). Any affirmative item response on a 5-point Likert scale was considered discrimination. We performed multivariable logistic regression examining DMS scores among Black non-Latinx, Latinx any race, other race non-Latinx (categorized as Black, Indigenous, People of Color (BIPOC)) compared to White non-Latinx participants.
Results: Participants (N=163) averaged 27(±6) years and self-identified as 36.2% Black non-Latinx, 28.8% White non-Latinx, 27.0% Latinx of any race, and 8.0% other non-Latinx. Most were unmarried/non-cohabitating (81.6%), publicly insured (52.8%), and <14 weeks gestational age (90.8%).
Few (15.3%) reported race/ethnicity-based discrimination during abortion care. BIPOC participants more commonly reported discrimination (adusted OR (aOR) 6.68, 95%CI 1.41-31.66) compared to White non-Latinx participants. Stratified by race/ethnicity, Black non-Latinx (aOR 9.18, 95%CI 1.79-47.16), Latinx (aOR 5.51, 95%CI 0.98-30.88) and other race non-Latinx participants (aOR 3.51, 95%CI 0.41-29.82) were more likely to experience discrimination compared to White non-Latinx.
Conclusions: BIPOC participants receiving abortion care were more likely to report discrimination, with Black non-Latinx reporting highest odds of discrimination compared to White non-Latinx participants. Larger studies in different regions are needed to verify our findings. Further research is warranted to understand BIPOC experiences of discrimination and identify effective intervention strategies.
© 2021 Published by Elsevier Inc.