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APHA Scientific Session and Event Listing

Recorded presentation

Diana Greene Foster, PhD¹, Eleanor Drey, MD, EdM², and Rebecca Jackson, MD². (1) University of California, San Francisco, Bixby Center for Reproductive Health Research & Policy, Advancing New Standards in Reproductive Health, 655 13th Street, Suite 201, Oakland, CA 94602, (510) 836-2128, greened@obgyn.ucsf.edu, (2) Department of Obstetrics, Gynecology and Reproductive Health, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Ave., Ward 6D, San Francisco, CA 94110

A recent study shows that 70% of the delay among women seeking second trimester abortions is in the time to suspect and test for pregnancy. Using a Cox Proportional Hazards model we identify significant factors associated with delay in each of three steps leading to the abortion: missed period to pregnancy test, pregnancy test to the first call made to obtain an abortion, first call to procedure. Data come from 399 women from 5 to 23 weeks gestation seeking abortion at an urban hospital. Delay in obtaining a pregnancy test was independently associated with a number of factors: unsure LMP (HR 0.6), prior second-trimester abortions (HR 0.6), use of drugs or alcohol (HR 0.7), obesity/overweight (HR 0.8), denial (HR 0.8) and fear (HR 0.7). Protective factors included nausea and vomiting (HR 1.3) and tiredness (HR 1.5), which was associated with women testing for pregnancy significantly earlier. Delay in making the first call to obtain an abortion was associated only difficulty obtaining Medi-Cal (HR (0.6) and uncertainty (HR 0.6). Delay in the final step of obtaining the abortion was associated with initial referral to other clinics (HR 0.6), difficulty financing the abortion (HR 0.7), prior second-trimester abortion (HR 0.7) and having an unsupportive partner (HR 0.7).

Learning Objectives:

• Describe the reasons women delay seeking second trimester abortion care
• Describe the protective factors that prevent seeking later care
• Discuss the use of a survival analysis in assess delay for care

Keywords: Abortion, Health Disparities

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation