Abstract
Objective
: Explore relationships of race and ethnicity with experiences of race- or ethnicity-based
discrimination during abortion care.
Study Design
: English- or Spanish-speaking individuals aged 18-50 completed cross-sectional, self-administered
online surveys within 30 days of procedural abortion at five Northeastern U.S. reproductive
health clinics from June 2020-February 2021. We considered any affirmative response
on the Discrimination in Medical Settings (DMS) scale evidence of race- or ethnicity-based
discrimination. We performed bivariate analyses and logistic regression examining
discrimination among Black non-Latinx, Latinx any race, Other race non-Latinx compared
to White non-Latinx participants. We assessed associations between discrimination
and healthcare quality and satisfaction.
Results
: Participants (n=163) averaged 27(±6) years and self-identified as Black non-Latinx
(36.2%), White non-Latinx (28.8%), Latinx of any race (27.0%), and Other non-Latinx
(8.0%). Most were publicly insured (52.8%) and <14 weeks gestation (90.8%).Overall,
15.3% reported race- or ethnicity-based discrimination during abortion care with Black
non-Latinx more likely to report discrimination (23.7%; OR 7.00, 95%CI 1.50-32.59),
while Latinx any race (15.9%, OR 4.26, 95%CI 0.83-21.74) and Other race non-Latinx
participants (15.4%, OR 4.09, 95%CI 0.52-32.35) demonstrated statistically non-significant
trend toward increased odds of discrimination compared to White non-Latinx (4.3%).
Discrimination was associated with negative perceptions of: time with physician (p=0.03),
patient care involvement (p<0.05), physician communication (p=0.01), care quality
(p=0.02), and care satisfaction (p<0.01).
Conclusion
: Racially minoritized participants were more likely to report race- or ethnicity-based
discrimination during abortion care; Black non-Latinx reported highest odds of discrimination
compared to White non-Latinx. Discrimination was associated with unfavorable healthcare
quality measures.
Implications
: Race- or ethnicity-based discrimination during abortion care is disproportionately
reported by racially minoritized populations, especially Black individuals, compared
to White non-Latinx individuals. Discrimination is significantly associated with negative
experiences of care. Future work should verify findings in different regions and larger
studies, and design and test discrimination-reduction interventions.
Keywords
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Article info
Publication history
Accepted:
December 27,
2022
Received in revised form:
December 23,
2022
Received:
June 1,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Published by Elsevier Inc.
