Determinants of demand: method selection and provider preference among US women seeking abortion services.
BACKGROUND
Medication abortion has the potential to increase abortion availability, primarily through new provider networks; however, without a better understanding of how and why women make decisions regarding both their abortion method and their provider, expansion efforts may be misguided and valuable resources may be wasted.


METHODS
We undertook an exploratory study to investigate method and provider preferences. Semistructured one-on-one interviews were conducted with 205 abortion clients at three family planning clinics.


RESULTS
Study participants greatly preferred the clinic setting for their abortion; the majority of women in the study would not have gone to their regular physician if they had been given the option. In addition, method choice trumps provider choice for the majority of women who would have preferred their regular provider. Participants who chose the aspiration procedure were more likely to have previous knowledge about the medication method. Travel time was not a predictor of preferring one's regular physician over the clinic.


CONCLUSIONS
Expanding provider networks via the private sector is unlikely to be a panacea. In addition to these efforts, more attention may need to be paid to addressing logistic barriers to access. Physicians offering abortion services need to let their patients know they offer such services prior to their patients' need for them. Questions remain regarding the information being circulated about medication abortion.
Shochet
Tara
T
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. tara-shochet@uiowa.edu
Trussell
James
J
D000019:Abortifacient Agents; D000028:Abortion, Induced / Q000379:methods* / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D014481:United States; D014619:Vacuum Curettage
D000019:Abortifacient Agents