Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Nancy L. Stanwood

Subject Area(s)

Obstetrics and gynecology, Medicine

Abstract

Objectives: When contraceptive and abortion care are separated, women having abortions may not tell their contraceptive provider about their method failure and abortion. We examined abortion disclosure rates to contraceptive providers, reasons for abortion nondisclosure, and factors associated with disclosure.

Methods: We conducted a voluntary, anonymous, self-administered survey of 202 women seeking medical or surgical abortion from Planned Parenthood of Southern New England to determine abortion disclosure rates to their contraceptive providers, and collected demographics, reproductive health history, and contraceptive provider statistics. We calculated descriptive statistics and logistical regression modeling around disclosure of abortion.

Results: Almost half of women (44%) did not disclose their abortion to their contraceptive providers. The most common reasons for nondisclosure of the abortion were "I don't want them to know I'm having an abortion" (44%), "I'm changing providers" (20%), embarrassment about the pregnancy (14%), and fear of judgment (14%). Compared to Planned Parenthood contraceptive providers, women were 72% less likely to disclose to an obstetrical/gynecological provider (adjusted OR 0.28, 95% CI 0.10- 0.75) and 90% less likely to disclose to a non-obstetrical/gynecologic provider (adjusted OR 0.10, 95% CI 0.02-0.42). Age, race/ethnicity, income, and education were not significantly associated with abortion disclosure.

Conclusions: We found that only provider type was significantly associated with disclosure, while intrinsic characteristics of the women were not. This suggests that abortion stigma is pervasive and affects women from many walks of life. It is concerning that abortion stigma may be a significant factor compromising effective contraceptive counseling and patient/provider relationships.

Comments

This is an Open Access Thesis.

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