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Expanded Access to Postabortion Contraception under Oregon's Reproductive Health Equity Act

Published:November 06, 2021DOI:https://doi.org/10.1016/j.whi.2021.10.001

      Abstract

      Objective

      We describe the first 24 months of expanded family planning services for low-income immigrants under Oregon's Reproductive Health Equity Act. We examined postabortion contraceptive use in rural versus urban locations.

      Study Design

      We conducted a historical cohort study of abortion services reimbursed under the Reproductive Health Equity Act in the first 2 years after its implementation (2018 and 2019). Our primary outcome was shift in contraceptive tier from a less effective method before an abortion to a more effective contraceptive method after an abortion. Our key independent variable was residence in a metropolitan or nonmetropolitan area. We tested the association of nonmetropolitan residence and shift to a tier 1 or tier 2 method after the abortion, controlling for other factors, using logistic regression.

      Results

      Our analysis included 625 abortions from across the state. After an abortion, 68% of women transitioned to a more effective form of contraception. Nonmetropolitan residence was not significantly associated with a shift from no method or a tier 3 method to tier 1 or tier 2 method (adjusted odds ratio, 1.28; 95% confidence interval, 0.81–2.02) compared with metropolitan residence.

      Conclusions

      The program was successful in helping women not wishing pregnancy to transition to a more effective contraceptive method postabortion, regardless of metropolitan location of residence.
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      Biography

      Maria I. Rodriguez, MD, MPH, is an Associate Professor of Obstetrics and Gynecology and the Medical Director for the state of Oregon's Reproductive Health program. She is Deputy Editor of the Cochrane Fertility Regulation Group, newly housed at OHSU.

      Biography

      Megan Skye, MPH, is a Research Associate in the Department of Obstetrics & Gynecology at OHSU.

      Biography

      Mitra Shokat, BA, is a medical and public health graduate student at OHSU.

      Biography

      Rachel Linz, MPH, is a senior research analyst at the Oregon Health Authority's Reproductive Health Program.

      Biography

      Nisreen Pedhiwala, MPH, is a research analyst at the Oregon Health Authority's Reproductive Health Program.

      Biography

      Blair G. Darney, PhD, MPH, is an Associate Research Professor of Obstetrics and Gynecology.