Abstract
Purpose
This paper examines how Utah's two-visit requirement and 72-hour waiting period influence
women's certainty about their decision to have an abortion.
Procedures
This study uses data from a prospective cohort study of 500 women who presented at
an abortion information visit at four Utah family planning facilities. At the information
visit, participants completed a baseline survey; 3 weeks later, they completed telephone
interviews that assessed their pregnancy outcome, change in certainty, and factors
affecting changes in certainty.
Main Findings
Overall, 63% reported no change in certainty owing to the information visit and 74%
reported no change in certainty owing to the waiting period. Changes in certainty
were primarily in the direction of increased certainty, with more women reporting
an increase (29%) than a decrease (8%) in certainty owing to the visit and more women
reporting an increase (17%) than a decrease (8%) owing to waiting. Changes in certainty
in either direction were concentrated among the minority (8%) who were conflicted
about their decision at baseline. Learning about the procedure, meeting staff, and
discovering that the facility was a safe medical environment were main contributors
to increased certainty.
Conclusion
Most women were certain of their decision to have an abortion when they presented
for their abortion information visit and their certainty remained unchanged despite
the information visit and 72-hour waiting period. Changes in certainty were largely
concentrated in the minority of women who expressed uncertainty about their decision
before the beginning of the information visit. Thus, individualized counseling for
the minority who are conflicted when they first present for care seems more appropriate
than universal requirements.
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References
- Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer.Patient Education and Counseling. 2013; 91: 364-371
- Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the ‘red states v. blue states’ hypothesis.Culture, Health, & Sexuality. 2015; 17: 733-746
- Invasive prenatal testing decisions in pregnancy after infertility.Prenatal Diagnosis. 2010; 30: 575-581
- Stable resource toolkit: AUDIT-C-overview.2015 (Available at:) (Accessed: September 28, 2015)
- Identifying women in need of further discussion about the decision to have an abortion and eventual outcome.Contraception. 2013; 88: 128-132
- Attitudes and decision making among women seeking abortions at one US clinic.Perspectives on Sexual and Reproductive Health. 2012; 44: 117-124
- Relationship between ultrasound viewing and proceeding to abortion.Obstetrics and Gynecology. 2014; 123: 81-87
- Patient education and emotional support practices in abortion care facilities in the United States.Womens Health Issues. 2012; 22: e359-e364
- Counseling and waiting periods for abortion. State Policies in Brief.2016 (Available at: http://www.guttmacher.org/statecenter/spibs/spib_MWPA.pdf. Accessed: December 21, 2016)
- The impact of Mississippi's mandatory delay law on abortions and births.JAMA. 1997; 278: 653-658
- The impact of state mandatory counseling and waiting period laws on abortion: A literature review.Guttmacher Institute, New York2009: 2009
- Abortion patients' experience and perceptions of waiting periods: Survey evidence before Arizona's two-visit 24-hour mandatory waiting period law.Womens Health Issues. 2016; 26: 60-66
- Waiting periods and the rising price of abortion. The Atlantic.2015 (Available at:) (Accessed: June 8, 2015)
- Intentions for bilateral mastectomy among newly diagnosed breast cancer patients.Journal of Surgical Oncology. 2013; 107: 772-776
- Decision making and referral prior to abortion: A qualitative study of women's experiences.Journal of Family Planning and Reproductive Health Care. 2004; 30: 51-54
- Evaluation of the effect of a patient decision aid about vasectomy on the decision-making process: A randomized trial.Contraception. 2010; 82: 556-562
- Beliefs about abortion risks in women returning to the clinic after their abortions: A pilot study.Contraception. 2014; 90: 19-22
- How patients view mandatory waiting periods for abortion.Family Planning Perspectives. 1981; 13: 75-79
- User manual: Decisional Conflict Scale (16 item statement format).1993 (Available at:) (Accessed: March 21, 2014)
- Validation of SURE, a four-item clinical checklist for detecting decisional conflict in patients.Medical Decision Making. 2013; 34: 54-62
- Measuring decisional certainty among women seeking abortion.Contraception. 2017; 95: 269-278
- Utah's 72-Hour Waiting Period for Abortion: Experiences Among a Clinic-Based Sample of Women.Perspectives on Sexual and Reproductive Health. 2016; 48: 179-187
- Predictors of bariatric surgery among an interested population.Surgery for Obesity and Related Disorders. 2014; 10: 547-552
“Sure”(n.d.). Available at: Merriam-Webster.com. Accessed: February 29, 2016.
- Decision aids for people facing health treatment or screening decisions.Cochrane Database of Systematic Reviews. 2014; : CD001431
- Misperceptions about the risks of abortion in women presenting for abortion.Journal of Obstetrics and Gynaecology Canada. 2014; 36: 223-230
- Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver.American Journal of Public Health. 2013; 103: 454-461
Biography
Sarah C.M. Roberts, DrPH, is Associate Professor at University of California, San Francisco. Dr. Roberts studies how policies and our health care system punish rather than support vulnerable pregnant women, including women seeking abortion and women who use alcohol and/or drugs.
Biography
Elise Belusa, MSc, is Strategy Officer at Tara Health Foundation. At the time of the study, Ms. Belusa worked as Research Manager at the University of California, San Francisco.
Biography
David K. Turok, MD, MPH, is an Associate Professor in the University of Utah Department of Obstetrics and Gynecology. His clinical and research efforts are focused on family planning.
Biography
Sarah Combellick, MPH, was Project Director at Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco at the time of the study.
Biography
Lauren Ralph, PhD, MPH, is an epidemiologist at Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. Her research examines the causes and consequences of unintended pregnancy, with a focus on adolescents and young adults.
Article info
Publication history
Published online: April 05, 2017
Accepted:
February 10,
2017
Received in revised form:
February 8,
2017
Received:
October 20,
2016
Footnotes
Study location: Salt Lake City, UT.
Identification
Copyright
© 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc.
