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Risk factors associated with presenting for abortion in the second trimester
Eleanor A Drey1, Diana G Foster, Rebecca A Jackson
1Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA, USA. dreye@obgyn.ucsf.edu
Obstetrics and Gynecology
|January 6, 2006
Summary
Delayed abortions are often caused by logistical issues and late pregnancy recognition. Public health efforts should focus on earlier testing and improved access to care for women seeking abortions.
Area of Science:
- Reproductive Health
- Public Health
- Medical Sociology
Background:
- Induced abortion is a common procedure, but delays in seeking care can lead to second-trimester abortions.
- Factors contributing to these delays are complex and multifactorial, impacting patient outcomes and healthcare access.
Purpose of the Study:
- To identify the specific factors associated with delaying induced abortion until the second trimester of pregnancy.
- To understand the sequential steps and reasons contributing to delayed abortion decisions.
Main Methods:
- Audio computer-assisted self-interviewing was used with 398 women presenting for abortion between 5 and 23 weeks of gestation.
- Multivariable logistic regression analysis was employed to determine independent predictors of delayed abortion.
Main Results:
- Later suspicion and testing for pregnancy were primary drivers, contributing to 58% of second-trimester cases missing the first-trimester window.
- Women undergoing second-trimester abortions reported more delaying factors (3.2 vs. 2.0) and logistical delays (63.3% vs. 30.4%).
- Key factors for second-trimester abortion included prior second-trimester abortion, delayed state insurance, provider access issues, and menstrual uncertainty.
Conclusions:
- Abortion delays stem from numerous logistical challenges, including referral issues and public insurance access.
- Public health interventions should target earlier pregnancy recognition, streamlined referrals, accessible funding, and improved access for underserved populations.
- Accessible second-trimester abortion services remain crucial for individuals experiencing delayed pregnancy recognition.
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