Predictors of Abortion Counseling Receipt and Helpfulness in the United States

  • Heather Gould
    Correspondence
    Correspondence to: Heather Gould, MPH, 1330 Broadway, Suite, 1100 Oakland, CA 94612. Phone: +1 510 986 8936; fax: +1 510 986 8960.
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH) Program, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, California
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  • Diana Greene Foster
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH) Program, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, California
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  • Alissa C. Perrucci
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH) Program, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, California
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  • Rana E. Barar
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH) Program, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, California
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  • Sarah C.M. Roberts
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH) Program, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, California
    Search for articles by this author

      Abstract

      Background

      Little is known about women's expectations, needs, and experiences with abortion counseling and the factors that influence their experiences.

      Methods

      This study sought to investigate individual- and facility-level factors that influenced women's reports of receiving abortion counseling and the helpfulness of counseling. Data were drawn from quantitative interviews with 718 patients recruited from 30 abortion facilities, and 27 interviews with facility informants in the United States.

      Findings

      Sixty-eight percent of participants reported receiving counseling; reports varied by facility. Almost all participants who reported receiving counseling described counseling as helpful: 40% extremely, 28% quite, 17% moderately, 10% a little, and 4% not at all. Nearly all (99%) reported that their counselor communicated support for whatever decision they made. No individual-level factors predicted counseling receipt or helpfulness. Facility informant reports that it is their role to counsel patients about emotional issues was positively associated with women's reports of counseling receipt ( p < .001). Women at facilities subject to laws requiring provision of specific information and/or state-approved, written materials had lesser odds of finding counseling helpful, compared with women at facilities not subject to such laws ( p < .01).

      Conclusions

      Legal mandates that regulate abortion counseling do not seem to be helpful to women. More research is needed to understand the effects of abortion counseling and whether policies regulating counseling have a deleterious effect on women.
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      Biography

      Heather Gould, MPH, is research coordinator for the Turnaway Study and several related studies at ANSIRH. She is interested in women's reproductive health outcomes related to unintended pregnancy, abortion and childbirth, as well as their experiences accessing and receiving health services.

      Biography

      Diana Greene Foster, PhD, is a demographer who uses quantitative models and analyses to evaluate the effectiveness of family planning policies and the effect of unintended pregnancy on women's lives. She is the Principal Investigator of the Turnaway Study.

      Biography

      Alissa C. Perrucci, PhD, MPH, is the Counseling & Administrative Manager at the Women's Options Center at San Francisco General Hospital. Her book Decision Assessment and Counseling in Abortion Care: Philosophy and Practice was published by Rowman & Littlefield in 2012.

      Biography

      Rana E. Barar, MPH, is the project director for the Turnaway Study and several other abortion- and family planning-related studies.

      Biography

      Sarah C.M. Roberts, DrPH, is a public health social scientist. She studies policy and social determinants of women's health, with a focus on alcohol and drug use in the context of pregnancy, parenting, and reproductive health.