title: Delayed pregnancy testing and second-trimester abortion: can public health interventions assist with earlier detection of unintended pregnancy?
abstract: BACKGROUND
  Delayed pregnancy testing has been associated with presentation for abortion in the second trimester. Little is known about acceptability of potential interventions to hasten pregnancy recognition.
  
  
  METHODS
  A total of 592 women presenting for abortion at six clinics in the United States completed surveys on contraceptive use, risk behavior, timing of first pregnancy test and interest in interventions to speed pregnancy recognition and testing.
  
  
  RESULTS
  Forty-eight percent of women presenting for second-trimester abortion delayed testing until at least 8 weeks. In multivariate analysis, women who often spotted between periods had higher odds of delaying pregnancy testing [odds ratio (OR) 2.7, 95% confidence interval (CI) 1.04-6.94]. Women who often missed periods had higher odds of second-trimester abortion (OR 2.1, 95% CI 1.34-3.13). The majority (64%) of women were not aware of a fertile time in the menstrual cycle; these women had higher odds of second-trimester abortion (OR 2.0, 95% CI 1.21-3.37). Ninety-four percent of women expressed interest in at least one potential intervention to help recognize pregnancy earlier.
  
  
  CONCLUSIONS
  While there was near-universal interest in earlier pregnancy recognition, no single proposed intervention or scenario was endorsed by the majority. Improving sexual health awareness is an important consideration in future efforts to expedite pregnancy testing.
  
  
  CONCLUSIONS
  We found near-universal interest in earlier pregnancy recognition, though no single proposed intervention or scenario garnered majority support. Based on our findings, the concept of improving sexual health awareness through education should be incorporated in the development of future strategies to hasten recognition of unintended pregnancy.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA 94143. Electronic address: swansonm@obgyn.ucsf.edu.
authors.forename: Megan
authors.initials: M
authors.lastname: Swanson
authors.affiliation: School of Public Health, University of California, Berkeley, CA 94720.
authors.forename: Deborah
authors.initials: D
authors.lastname: Karasek
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA 94110.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Drey
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA 94110.
authors.forename: Diana Greene
authors.initials: DG
authors.lastname: Foster
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011258:Pregnancy Tests / Q000706:statistics & numerical data*; D011262:Pregnancy Trimester, Second; D011275:Pregnancy, Unwanted; D055815:Young Adult
keywords: Abortion; Delay; Health knowledge, Attitudes, Practice; Pregnancy; Pregnancy test