Rural-urban differences in clinic capacity for referrals and proximity to abortion services among Title X family planning clinics
Federal statutes allow Title X providers to offer factual and nondirective options counseling to its pregnant clients, but scant published data exist on the practice of options counseling in Title X clinics.
Referral and proximity data were analyzed from a larger study which surveyed 558 Title X family planning clinics in 16 Great Plains and Midwestern U.S. states from June-September 2012 regarding clinic accessibility, contraceptive methods provided, and perceived barriers. Descriptive analyses were performed to examine the proportion of clinics that provided counseling on abortion and adoption services and the proximity of abortion services to clinics by rural/urban status.
While 97% of surveyed clinics reported referring patients to adoption services upon request, 84% of clinics reported referring clients to abortion services upon request. Rural clinics were more likely than urban clinics to report the closest 1st trimester provider (47% vs. 7%, p<0.001) and the closest 2nd trimester provider (40% vs. 13%, p<0.001) to be located 101 or more miles away. Rural clinics were more likely than urban clinics to report not knowing where the closest 1st trimester (15% vs. 6%, p<0.001), 2nd trimester (38 vs. 22%, p<0.001) and medication (35% vs. 22%, p<0.001) abortion providers were located.
Conclusions: Major differences in abortion referral capacity exist by rural/urban status of Title X clinics. These findings may reflect the increasingly restrictive environment for abortion services in the Midwest. Potential interventions include: better education about abortion referral for family planning providers and telemedicine services for rural providers.
Learning Areas:Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Describe counseling and referral practices for abortion and adoption in Midwestern and Great Plains Title X clinics. Compare clinic capacity for referrals and proximity to abortion services by rural-urban status.
Keyword(s): Abortion, Health Care Access
Qualified on the content I am responsible for because: I am a doctoral-trained maternal and child health researcher with over 12 years of experience in public health. My research interests broadly include health disparities, women and childrenâs health, behavioral science, and social determinants of health.
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.