Abstract
Background
Women's preferences for postabortion contraceptive care vary, and some may experience
difficulties realizing their preferences owing to health systems-level barriers. We
assessed Mississippi women's interest in postabortion contraceptive counseling and
method use and the extent to which their method preferences were met.
Methods
In 2016, women ages 18 to 45 completed a self-administered survey at their abortion
consultation visit in Mississippi and a follow-up phone survey 4–8 weeks later. Thirty-eight
participants were selected for in-depth interviews. We computed the percentage of
women who were interested in contraceptive counseling, initiating a method, and who
obtained a method at the clinic. We also calculated the percentage who were using
their preferred method after abortion and the main reasons they were not using this
method. We analyzed transcripts using a theme-based approach.
Results
Of 323 women enrolled, 222 (69%) completed the follow-up survey. Of those completing
follow-up, more than one-half (58%) reported that their consultation or abortion visit
was the best time for contraceptive counseling, and 69% wanted to initiate contraception
at the clinic. Only 10% obtained a method on site, and in-depth interview respondents
reported they could not afford or did not like the options available. At the follow-up
survey, 23% of respondents were using their preferred method. Women cited cost or
lack of insurance coverage and difficulties scheduling appointments with community
clinicians as reasons for not using their preferred method.
Conclusions
Mississippi women have a large unmet demand for postabortion contraception. Policies
that support on-site provision of contraception at abortion facilities would help
women to realize their contraceptive preferences.
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Biography
Kari White, PhD, MPH, is an Associate Professor, Steve Hicks School of Social Work and Department of Sociology at the University of Texas at Austin. She studies the effect of policies on family planning service delivery and women's access to reproductive health care.
Biography
Kaitlin J. Portz, PhD, is a Psychologist at Barnes-Jewish Hospital Center for Advanced Medicine. She is interested in sexual health promotion and transgender health.
Biography
Samantha Whitfield, MPH, is a Program Manager at the University of Alabama at Birmingham, School of Public Health. She is interested in minority population health, sexual health promotion, and infectious disease, including HIV and STI prevention.
Biography
Sacheen Nathan, MD, MPH, is the Medical Director at Jackson Women's Health Organization.
Article info
Publication history
Published online: February 21, 2020
Accepted:
January 17,
2020
Received in revised form:
December 22,
2019
Received:
March 20,
2019
Footnotes
Conflict of Interest Statement: The authors declare that they have no conflicts of interest.
Identification
Copyright
© 2020 Jacobs Institute of Women's Health. Published by Elsevier Inc.
