Factors affecting the timing of abortion in New York City

Introduction: Second trimester abortions are associated with increased costs, medical risks, and legal restrictions. This study aims to identify modifiable factors that impact timing of abortion. Methods: Women seeking a surgical abortion were asked to complete a 22-item self-administered questionnaire at a large abortion clinic in New York City in 2009. Gestational age was determined by ultrasound. Women in the second trimester were over-sampled to increase statistical power. The final sample included 296 first trimester (≤ 12 weeks) and 174 second trimester (13-24 weeks) patients. About 25% of subjects discussed their responses in an informal interview. Analysis: Preliminary analyses indicate that second trimester abortion patients were significantly (p < 0.05) younger, less likely to have a high school diploma, less like to be married, more likely to have had a previous abortion and more likely be living outside NYC. Preference to have had the abortion earlier was expressed by both first trimester (57.6%) and second trimester (86.1%) patients. Among first trimester patients, 23.1% said nothing slowed down the timing of the procedure, compared to 1.2% of second trimester patients. The most commonly cited barriers for second trimester patients were late knowledge of pregnancy and insurance delays. Conclusion: Women's preference for earlier abortion requires improved access to services, especially those related to pregnancy testing, acquisition of insurance, and availability of second trimester providers.