Predictors of delay in each step leading to an abortion.
BACKGROUND
Approximately 1 out of 10 abortions in the United States occurs in the second trimester of pregnancy. This study uses survival analysis to identify the factors which delay each step of the process of obtaining an abortion.


METHODS
This is a secondary data analysis of a cross-sectional study investigating a sample of 398 women who presented for elective abortion at an urban hospital. Respondents completed a survey using an audio-assisted self-interviewing program and provided a timeline for their process of obtaining an abortion.


RESULTS
In our analysis, we divided the abortion process into three steps ending in three distinct events (first pregnancy test, calling a clinic, getting an abortion). Factors associated with delay during the first step include obesity [hazard ratio (HR) 0.8, 95% CI 0.6-1.0], abuse of drugs or alcohol (HR 0.7, 95% CI 0.6-1.0), prior second-trimester abortion (HR 0.6, 95% CI 0.4-0.8) and being unsure of last menstrual period (HR 0.6, 95% CI 0.4-0.7) and emotional factors such as being in denial (HR 0.8, 95% CI 0.6-1.0) and fear of abortion (HR 0.7, 95% CI 0.5-1.0).


CONCLUSIONS
This study identified key factors associated with delay in obtaining abortion care. Interventions which seek to address these factors, especially those factors associated with later pregnancy suspicion and testing, may reduce abortion delay and facilitate women obtaining their abortions when medical risk and overall cost are lower.
Foster
Diana G
DG
Advancing New Standards in Reproductive Health, Bixby Center for Reproductive Health Research and Policy, University of California-San Francisco, San Francisco, CA 94110, USA. greened@obgyn.ucsf.edu
Jackson
Rebecca A
RA
Cosby
Kate
K
Weitz
Tracy A
TA
Darney
Philip D
PD
Drey
Eleanor A
EA
D000028:Abortion, Induced / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D002140:California; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000523:psychology*; D016016:Proportional Hazards Models