Abstract
Objectives
Assess preferences for and use of medication abortion in Texas after implementation
of two policy changes: a 2013 state law restricting medication abortion and the FDA
label change for mifepristone in 2016 nullifying some of this restriction.
Study design
We analyzed surveys conducted in 2014 and 2018 with abortion patients at 10 Texas
abortion facilities. We calculated the percentage of all respondents with an initial
preference for medication abortion by survey year, and the type of abortion obtained
or planned to obtain among those who were at <10 weeks of gestation. We used multivariable-adjusted
mixed-effects Poisson regression models to assess factors associated with medication
abortion preference and actual/planned use.
Results
Overall, 156 (41%) of 376 respondents in 2014 and 247 (55%) of 448 respondents in
2018 reported initial preference for medication abortion (Prevalence ratio [PR]: 1.28;
95% CI 1.03−1.59). Among those who were <10 weeks of gestation and initially preferred
medication abortion, 39 of 124 (31%) obtained or were planning to obtain the method
in 2014, compared with 188 of 223 (84%) in 2018 (PR: 2.65; 95% CI: 1.69−4.15). After
multivariable adjustment, respondents who initially preferred medication abortion
and were 7 to 9 weeks of gestation at the time of their ultrasonography (vs <7 weeks)
were less likely to obtain or plan to obtain the method (PR: 0.69; 95% CI: 0.57−0.84).
Conclusions
Abortion patients were more likely to prefer and obtain or plan to obtain their preferred
medication abortion after legal restrictions in Texas were nullified.
Implications
State policies can affect people's ability to obtain their preferred abortion method.
Efforts to provide both abortion options whenever possible, and inform people where
each can be obtained, remains an important component of person-centered care despite
increasing state abortion restrictions and bans following the reversal of Roe v Wade.
Keywords
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Article info
Publication history
Published online: December 02, 2022
Accepted:
November 17,
2022
Received in revised form:
November 14,
2022
Received:
November 8,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
