Characteristics and Circumstances of US Women Who Obtain Very Early and Second Trimester Abortions
Characteristics and Circumstances of US Women Who Obtain Very Early and Second Trimester Abortions
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DOI：
10.1371/journal.pone.0169969
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发表时间：
2017-01-25
期刊：
影响因子：
3.7
通讯作者：
Jerman, Jenna
中科院分区：
文献类型：
--
作者：
Jones, Rachel K.;Jerman, Jenna
目的确定哪些特征和情况与早中期妊娠流产有关。方法纸质和铅笔调查来自2014年和2015年全国范围内的8380名非住院堕胎患者。我们使用自我报告的LMP来计算妊娠周数；当没有提供LMP时，我们使用自我报告的怀孕周。我们构建了两个因变量：非常早期流产，定义为怀孕六周或更早，以及获得中期流产，定义为怀孕13周或更晚。我们检查了两种妊娠测量与一系列特征和情况之间的关系，包括患者居住状态下的堕胎等待时间类型。结果在早期妊娠流产患者中，降低非常早期堕胎可能性的特征包括年龄在20岁以下，依赖经济援助来支付手术费用，最近暴露在两个或更多破坏性事件中，以及在手术前24-72小时生活在需要面对面咨询的状态。拥有大学学位和及早承认怀孕会增加很早就堕胎的可能性。增加中期妊娠流产可能性的特征包括黑人、高中学历以下、依赖经济援助来支付堕胎费用、居住在距离堕胎设施25英里或更远的地方以及较晚识别怀孕。结论虽然经济援助的提供可能允许妇女获得堕胎，但这也可能导致获得医疗保健的延迟。如果贫困妇女拥有涵盖堕胎服务的医疗保险，这些延误就可以得到缓解。自研究期间以来，又有四个州开始要求妇女在堕胎前获得面对面的咨询，这些法律的增加可能会减缓极早期堕胎的趋势。
ObjectiveTo determine which characteristics and circumstances were associated with very early and second-trimester abortion.MethodsPaper and pencil surveys were collected from a national sample of 8,380 non-hospital U.S. abortion patients in 2014 and 2015. We used self-reported LMP to calculate weeks gestation; when LMP was not provided we used self-reported weeks pregnant. We constructed two dependent variables: obtaining a very early abortion, defined as six weeks gestation or earlier, and obtaining second-trimester abortion, defined as occurring at 13 weeks gestation or later. We examined associations between the two measures of gestation and a range of characteristics and circumstances, including type of abortion waiting period in the patients' state of residence.ResultsAmong first-trimester abortion patients, characteristics that decreased the likelihood of obtaining a very early abortion include being under the age of 20, relying on financial assistance to pay for the procedure, recent exposure to two or more disruptive events and living in a state that requires in-person counseling 24-72 hours prior to the procedure. Having a college degree and early recognition of pregnancy increased the likelihood of obtaining a very early abortion. Characteristics that increased the likelihood of obtaining a second-trimester abortion include being Black, having less than a high school degree, relying on financial assistance to pay for the procedure, living 25 or more miles from the facility and late recognition of pregnancy.ConclusionsWhile the availability of financial assistance may allow women to obtain abortions they would otherwise be unable to have, it may also result in delays in accessing care. If poor women had health insurance that covered abortion services, these delays could be alleviated. Since the study period, four additional states have started requiring that women obtain in-person counseling prior to obtaining an abortion, and the increase in these laws could slow down the trend in very early abortion.