Exploring provider preference and provision of abortion methods and stigma: Secondary analysis of a United Kingdom provider survey

Abstract

IntroductionMethod choice is an important component of quality abortion care and qualitative research suggests that abortion stigma can influence provider preference and provision of abortion methods. This study is the first to explore the relationships between abortion providers' method preferences, their provision of medication or instrumentation abortion or both methods, and abortion stigma.MethodsWe conducted secondary analysis of a survey of United Kingdom (UK) abortion providers (N = 172) to describe and compare providers' self‐reported method preferences and provision. We used multinomial logistic regression to assess the association between method preference and provider experiences of abortion stigma (measured using a revised Abortion Provider Stigma Scale (APSS)), adjusting for relevant provider and facility characteristics.ResultsAlmost half (52%) of providers reported that they only provided medication abortion care, while 5% only provided instrumentation abortion care and 43% provided both methods. Most (62%) preferred to provide both methods while 32% preferred to provide only medication abortion and 6% only instrumentation abortion. There was no significant difference in revised APSS scores by provider method preference or provision.DiscussionMost surveyed UK abortion providers prefer to offer both methods, but over half only provide medication abortion. This may reflect patients' preferences for medication abortion, and health system and legal constraints on instrumentation abortion. Addressing these systemic constraints on method provision could expand patient choice. Providers' method preference was not significantly associated with provider stigma but future research should consider the influence of structural stigma on method provision at the health system level.

Characteristics and contraceptive practices among Chinese women seeking abortion: a multicentre, descriptive study from 2019 to 2021

“…Previous studies have found that both practitioners and clients were more likely to provide/choose a medical method where medical abortion at home is legally permitted. [12][13][14] During the COVID-19 pandemic, the 'contactless' provision of the mifepristone-misoprostol medication abortion care strategy was extensively validated as safe and effective and was popular. 15 However, the preferences for provision/choice of abortion methods in China are still unknown.…”