Abstract
Objectives
Crisis pregnancy centers (CPCs) seek to dissuade people from having abortions. Twenty-five
states have policies supporting CPCs. We aimed: (1) to characterize access to early
pregnancy confirmation at CPCs compared to abortion facilities nationwide and (2)
to understand the role of state CPC policy in service access.
Study design
We conducted a national mystery caller study of 445 CPCs and geographically paired
abortion facilities, posing as patients seeking pregnancy confirmation. Facility type
(CPC vs abortion facility) was the primary exposure in Aim 1. Wait time to first available
early pregnancy appointment was the primary outcome. In Aim 2, state-level CPC policy
designation (supportive vs not supportive of CPCs) was the primary exposure. Difference
in wait time ≥7 days to first available appointment between CPCs and paired abortion
facilities was the primary outcome.
Results
CPCs were more likely than abortion facilities to provide same-day appointments (68.5%
vs 37.2%, p < 0.0001), and free pregnancy testing (98.0% vs 16.6%, p < 0.0001). The median wait to first available appointment at a CPC was 0 days (IQR
0,1), compared to 1 day at abortion facilities (IQR 0, 5), p < 0.0001.
In states with supportive CPC policy environments, abortion facilities were less likely
to have wait times exceeding their paired CPC by a week or more, compared to paired
facilities in states with non-supportive CPC policy environments (p = 0.033). This remained true after adjusting for state abortion policy environment
(p = 0.011).
Conclusions
Pregnancy confirmation is more accessible at CPCs compared to abortion facilities.
Factors other than state-level CPC policies likely influence service accessibility.
There is a need for improved access to pregnancy confirmation in medical settings.
Implications
Our findings demonstrating that pregnancy confirmation is more accessible at crisis
pregnancy centers than at abortion facilities are predicted to be exacerbated in the
wake of abortion clinic closures following the Dobbs v Jackson Women's Health Organization Supreme Court decision. This highlights the need for improved funding and support
for pregnancy confirmation service delivery in medical settings, including abortion
facilities.
Keywords
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Article info
Publication history
Published online: September 06, 2022
Accepted:
August 29,
2022
Received in revised form:
August 26,
2022
Received:
April 22,
2022
Footnotes
Conflicts of interest: KV received compensation as a Merck Nexplanon trainer from 2018 to 2019. BAC receives research grants from Medicines360, Sebela and Mylan, which are all managed by Magee-Womens Research Institute. SLA has received consulting fees from Mayne Pharma and Merck, and has received research grants from Estretra SRL, EvoFem, and Merck, which are managed by Magee-Womens Research Institute. The other authors report no conflicts of interest.
Funding: This study was conducted with support from the Society of Family Planning Research Fund, grant SFPRF19-07. The views and opinions expressed are those of the authors, and do not necessarily represent the views and opinions of SFPRF.
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