Comparison of Early Pregnancy Loss Management Between States With Restrictive and Supportive Abortion Policies

Elana Tal, Rachel Paul, Megan Dorsey, Tessa Madden

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Introduction: Mifepristone–misoprostol and office uterine aspiration used for abortion care are also evidence-based, cost-effective strategies for early pregnancy loss management. We aimed to compare the provision of mifepristone-misoprostol and office uterine aspiration for early pregnancy loss between states with restrictive and supportive abortion policies. Methods: We conducted a cross-sectional, internet-based survey regarding early pregnancy loss management among obstetrician–gynecologists (OBGYNs) at academic medical centers. We assessed management offered along with facilitators and barriers to implementation of mifepristone–misoprostol and office uterine aspiration. We used χ2 and multivariable logistic regression to compare practice patterns. Results: We analyzed responses from 350 physicians, 56% from states with restrictive abortion policies. OBGYNs in states with restrictive abortion policies were less likely than those in states with supportive abortion policies to offer both mifepristone–misoprostol and office uterine aspiration (33.2% vs. 51.3%; p = .001), to report having received induced abortion training (67.3% vs. 89.6%; p < .001), and to report perceived institutional support for abortion care (49.0% vs. 85.0%; p < .001). After adjusting for confounders, restrictive state policy was no longer associated with providing both mifepristone-misoprostol and office uterine aspiration for early pregnancy loss (adjusted odds ratio, 1.19; 95% confidence interval [CI], 0.58–2.45). However both prior induced abortion training and institutional support for abortion care remained significantly associated (adjusted odds ratio, 2.06; 95% CI, 1.07–3.97 and adjusted odds ratio, 3.91; 95% CI, 2.08–7.38, respectively). Conclusions: OBGYNs practicing in states with restrictive abortion policies are less likely than those in states with supportive abortion policies to have received abortion training or perceive institutional support for abortion care, and they are less likely to offer mifepristone–misoprostol and office uterine aspiration for early pregnancy loss.

Original languageEnglish
Pages (from-to)126-132
Number of pages7
JournalWomen's Health Issues
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2023

Fingerprint

Dive into the research topics of 'Comparison of Early Pregnancy Loss Management Between States With Restrictive and Supportive Abortion Policies'. Together they form a unique fingerprint.

Cite this