Abstract
Background
Abortion facilities represent a potentially convenient setting for providing contraception
to women experiencing unintended pregnancies. This analysis examines a range of factors
that may act as barriers to integrating contraceptive and abortion services and documents
abortion providers’ perspectives on their role in their patients’ contraceptive care.
Methods
Administrators from 173 large, nonhospital facilities that provide abortions in the
United States responded to a structured survey between May and September 2009. We
used chi-square tests to assess differences in categorical outcomes.
Results
Although the majority of U.S. abortion facilities offer a range of contraceptive methods
on site, facility staff identified multiple barriers to full integration of the two
services, in particular, insurance, patient, and cost barriers. Few of these perceived
barriers, however, were associated with differences in the actual provision of most
contraceptive methods. Specialized abortion clinics that do not accept health insurance
were less likely to have highly effective methods, such as intrauterine devices and
implants, on site. Facilities located in Medicaid states were more likely to accept
both public and private health insurance for contraceptive services.
Conclusion
Increased access to contraceptive services during abortion care is one strategy for
reducing repeat unintended pregnancy, and stakeholders at all levels—including abortion
providers, insurance companies, and policy makers—have a role to play in achieving
this goal.
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Biography
Megan Kavanaugh, DrPH, was an Ellertson Fellow from 2008–2010 and is now Senior Research Associate at the Guttmacher Institute, New York, NY. Her research portfolio has focused on unintended pregnancy, contraceptive use, post-abortion contraception and attitudes about abortion.
Biography
Rachel Jones, PhD, is also a Senior Research Associate at the Guttmacher Institute. Her work has focused on adolescent sexual health, abortion, and male sexual and reproductive health.
Biography
Lawrence Finer, PhD, is Director of Domestic Research at the Guttmacher Institute. He is responsible for supervising Guttmacher's research portfolio of U.S.-focused projects on family planning services, contraceptive services, contraceptive use patterns, pregnancy and abortion, and adolescent reproductive health.
Article info
Publication history
Accepted:
January 27,
2011
Received in revised form:
January 6,
2011
Received:
October 19,
2010
Footnotes
Supported by the Charlotte Ellertson Social Science Postdoctoral Fellowship in Abortion and Reproductive Health, an Ibis Reproductive Health program.
Identification
Copyright
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
