Aspects of Abortion Provision

Three new studies explore various aspects of the abortion experience. In the first, investigators examined the safety and acceptability of medication abortion without prior ultrasound or pelvic examination. Women requesting abortions at facilities in Mexico, Moldova, and the U.S. whose last menstrual period was within the past 56 days, had not used hormonal contraceptives within the past 3 months, and were not at risk for ectopic pregnancy underwent mifepristone/misoprostol medication abortion. Of 365 women, 347 had completed abortions, 5 required surgical aspirations, 10 required additional misoprostol, and 3 experienced serious adverse events (heavy bleeding; persistent gestational sac) unlikely to have been prevented by pretreatment ultrasound. Most (317) participants reported satisfaction with the streamlined procedure.

In the second study, a cross-sectional sample of 988 private U.S. obstetrician-gynecologist (OB/GYN) practices were asked if they provided abortions or referrals (response rate, 65% of 1961 surveys). Among respondents, 67 (7%) reported providing at least 1 abortion in 2013–2014; of these, 36 (54%) said that other physicians in the practice also provided abortions. Among nonproviders, 415 (54%) reported referring, 271 (35%) would not refer, and 87 (11%) referred “depending on the circumstances.” The most common reason for not referring was instead directing patients to information sources (e.g., Planned Parenthood website).

The third study concerned women's experiences with choosing to accept a printout of their preabortion ultrasound. Retroactive review of 5286 charts at a high-volume abortion clinic indicated 38% of patients had accepted printouts during a 2-year period spanning passage of a state law requiring display of ultrasound images. Women who accepted printouts were more likely to be younger, nonwhite, less educated, and not married compared with those who declined. Of 23 women interviewed, the 14 who had accepted printouts typically said they did so for “passive” reasons, curiosity or a desire to confirm the abortion decision; those who declined found the printouts “unnecessary.”