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.
Article info
Publication history
Published online: November 06, 2021
Accepted:
October 1,
2021
Received in revised form:
September 20,
2021
Received:
December 7,
2020
Footnotes
Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2021 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
