TY - JOUR
T1 - Comparison of Early Pregnancy Loss Management Between States With Restrictive and Supportive Abortion Policies
AU - Tal, Elana
AU - Paul, Rachel
AU - Dorsey, Megan
AU - Madden, Tessa
N1 - Funding Information:
Funding Statement: Supported by funds from the Society of Family Planning Research Fund (SFPRF 20–22). The funders had no role in the study design; collection, analysis and interpretation of data; writing of the manuscript; or the decision to submit the article for publication. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the Society of Family Planning. Dr. Madden serves on a data safety monitoring board for phase 4 safety studies of Bayer contraceptive products. The other authors do not have any potential conflicts of interest to report.
Publisher Copyright:
© 2022 Jacobs Institute of Women's Health, George Washington University
PY - 2023/3/1
Y1 - 2023/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85141939648&partnerID=8YFLogxK
U2 - 10.1016/j.whi.2022.10.001
DO - 10.1016/j.whi.2022.10.001
M3 - Article
C2 - 36379879
AN - SCOPUS:85141939648
SN - 1049-3867
VL - 33
SP - 126
EP - 132
JO - Women's Health Issues
JF - Women's Health Issues
IS - 2
ER -