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.
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.
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.
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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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.
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.
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.
Sacheen Nathan, MD, MPH, is the Medical Director at Jackson Women's Health Organization.
Published online: February 21, 2020
Accepted: January 17, 2020
Received in revised form: December 22, 2019
Received: March 20, 2019
Conflict of Interest Statement: The authors declare that they have no conflicts of interest.
© 2020 Jacobs Institute of Women's Health. Published by Elsevier Inc.