Consideration of and Reasons for Not Obtaining Abortion Among Women Entering Prenatal Care in Southern Louisiana and Baltimore, Maryland

Abstract

Most research about experiences considering and seeking abortion comes from women presenting at abortion clinics. This study examines experiences among women presenting at prenatal care. Five hundred eighty-nine women were recruited at their first prenatal visit in Southern Louisiana and Baltimore, Maryland. Participants completed self-administered iPad surveys and inclinic structured interviews. Participants were asked if they had considered abortion for this pregnancy and, if so, reasons they did not obtain one. Twenty-eight percent of Louisiana and 34% of Maryland participants had considered abortion. Ten percent in Louisiana and 13% in Maryland had called an abortion clinic; 2% in Louisiana and 3% in Maryland had visited an abortion clinic. The most common reason for not having an abortion related to women's own decision-making, i.e. their personal preferences. Policy-related reasons were less common; but more participants who had considered abortion in Louisiana than Maryland reported a policy-related reason (primarily lack of funding for the abortion) as a reason (22% Louisiana, 2% Maryland, p < 0.001). Recruiting in prenatal care is a feasible way to find women who considered, but did not obtain, an abortion for their current pregnancy. Women's own preferences were the primary reason for not obtaining an abortion across settings, but more in Louisiana than Maryland faced policy-related barriers to abortion.

Complex situations: Economic insecurity, mental health, and substance use among pregnant women who consider – but do not have – abortions

“…What these bans purport to accomplish-making abortion impossible to obtain in that state-is already happening in some states for some women [5,6]. There is a substantial and growing body of literature examining impacts of extant restrictive abortion policies and women's experiences of these policies Previous research indicates some restrictive abortion policies-such as gestational limits, laws requiring abortion providers to have hospital admitting privileges (and which can lead abortion clinics to close), lack of Medicaid funding to pay for low-income women's abortions, and multiple policies in combination-put abortion out of reach for some women [5][6][7][8][9].…”

“…What these bans purport to accomplish-making abortion impossible to obtain in that state-is already happening in some states for some women [5,6]. There is a substantial and growing body of literature examining impacts of extant restrictive abortion policies and women's experiences of these policies Previous research indicates some restrictive abortion policies-such as gestational limits, laws requiring abortion providers to have hospital admitting privileges (and which can lead abortion clinics to close), lack of Medicaid funding to pay for low-income women's abortions, and multiple policies in combination-put abortion out of reach for some women [5][6][7][8][9]. There is also a robust body of research that documents adverse impacts on women and children when women are unable to obtain wanted abortions; these include: economic insecurity, adverse physical health impacts, ongoing violence from the man involved in the pregnancy, and adverse impacts on children's development and maternal bonding [10][11][12][13][14].…”

Pregnant Women's Reasons for and Experiences of Visiting Antiabortion Pregnancy Resource Centers

“…In total, research coordinators approached 386 women in Louisiana and 367 in Maryland, representing 97% and 100%, respectively, of potentially eligible women. Of these potential participants, 70 did not meet all inclusion criteria, 94 did not consent to participate, 10 did not complete the iPad survey and 20 did not complete the interview, yielding an analytic sample of 559 women (269 in Louisiana and 290 in Maryland) …”

“…Of these potential participants, 70 did not meet all inclusion criteria, 94 did not consent to participate, 10 did not complete the iPad survey and 20 did not complete the interview, yielding an analytic sample of 559 women (269 in Louisiana and 290 in Maryland). 27 As part of the in-clinic interview, the research coordinators asked whether participants had visited a pregnancy resource center, defining such centers as "a place that offers free counseling specifically to women who are pregnant and sometimes also offers services like free ultrasounds and pregnancy tests. Pregnancy resource centers are also known as crisis pregnancy centers."…”

“…The distributions of these characteristics were generally similar to those of the overall study population. 27 At the time of their pregnancy resource center visit, most women were in the early stages of pregnancy: Nine were at less than six weeks' gestation, 10 were at 6-13 weeks' gestation and two were at more than 13 weeks' gestation.…”