247964 Women's experiences of legal abortion care provided in Mexico City's public facilities: A mixed-methods study, three years after decriminalization

Tuesday, November 1, 2011: 1:30 PM

Roula AbiSamra, MPH , Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA
Claudia Diaz, PhD , Research Center in Population and Health, Instituto Nacional de Salud Publica, Mexico City, Mexico
Sandra Garcia, ScD, ScM , Mexico Office, Population Council, Mexico City, Mexico
Patricio Sanhueza Smith, MD , Reproductive Health Coordinator, Ministry of Health, Mexico City Government, Mexico City, Mexico
Vanessa Cravioto, BA , Research Center in Population and Health, National Institute of Public Health of Mexico, Mexico City, Mexico
Olimpia Gomez, BA , Research Center in Population and Health, National Institute of Public Health of Mexico, Mexico City, Mexico
Introduction: In 2007, Mexico City's legislature decriminalized pregnancy terminations done by twelve weeks' gestation. Over 50,000 procedures have since been provided in designated Mexico City Ministry of Health (MOH) facilities. Objective: The goal of this research was to understand patients' experiences with abortion in the MOH program. Specific aims were to (1) measure characteristics, knowledge, and satisfaction of women who used misoprostol-only medical abortion compared to women who underwent the surgical protocol; (2) understand patients' perceptions of the care they received, of their own abortion experience, and of abortion in general; and (3) derive recommendations for improving the MOH program. Methods: 350 consenting women completed a questionnaire of demographics, steps taken to obtain services, and service satisfaction. A sub-sample of 20 patients also completed in-depth interviews (IDI) regarding their experiences. Statistical analysis includes bivariate and multiple logistic regression techniques to identify predictors of patient satisfaction with each method. Interview data are analyzed using a grounded theory approach. Results: Preliminary quantitative results indicate that patients had a mean age of 25 years, a high-school education, and were single. Approximately 90% had more than one child, and women aged 24-34 favored medical abortion while those aged 15-24 favored surgical abortion. Of the 350 women, 14.4% had attempted to self-induce an abortion prior to obtaining medical care. Attempts to self-induce an abortion during this pregnancy (using any method) was significantly associated with having prior knowledge of medical abortion regimens. Multivariate analysis and IDI findings are expected to be complete in late February.

Learning Areas:
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Program planning

Learning Objectives:
Name the concerns most commonly cited by patients of the public abortion provision program. Compare the background characteristics, knowledge level, and satisfaction of women undergoing medical vs. surgical abortion procedures. Discuss the perspectives that abortion patients express regarding their own abortion, the services and providers they encountered, and abortion in general.

Keywords: Abortion, Women's Quality Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am conducting both the qualitative and quantitative analysis of the data informing this presentation, and have worked with patients at various stages throughout their processes of seeking abortion care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.