Contraception · 2025
Preferred strategies for obtaining abortion care among pregnant Texans: A latent class analysis.
СтатьяНазвание и аннотация: Перевод в очереди
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Nagle Amanda, Beasley Anitra, Lerma Klaira, Sierra Gracia, Alvarez Pérez Gabriela, Grossman Daniel, White Kari
Аннотация
OBJECTIVE: In September 2021, Texas implemented Senate Bill 8 (SB8)- a law prohibiting abortion after detection of embryonic cardiac activity and was poised to ban all abortions with few exemptions if the US Supreme Court ended federal protections for abortion. Given restricted options for in-state facility-based care, we evaluated pregnant Texans' preferences for other strategies to obtain abortion care and assessed social and economic factors associated with their interest.
STUDY DESIGN: In June and July 2022, we recruited Texans ≥ 18 years of age attending the mandatory consultation and ultrasound visit at 8 in-state facilities for a survey about their interest in strategies to obtain an abortion if they could not do so in Texas. We asked about five strategies: out-of-state facility-based care; abortion on a ship off Texas' coast; asynchronous non-US-based telehealth; synchronous US-based telehealth; or use of misoprostol from Mexico. We used 3-step latent class analysis to identify clusters (or classes) of abortion seekers with similar preferences and multinomial regression analysis to assess the relationship between resource constraints and class membership.
RESULTS: Among 293 respondents with complete information, we identified four classes: amenable to most strategies (n = 209), amenable to in-person strategies (n = 39), amenable to at-home strategies (n = 20), and few strategies acceptable (n = 25). Class membership was related to care preferences, access to a reliable car, and concern about the legality and safety of abortion pills obtained online.
CONCLUSIONS: Most respondents were interested in all strategies, while those with transportation barriers and abortion modality concerns found fewer strategies acceptable.
IMPLICATIONS: Most Texans seeking abortion were interested in a variety of in-person and virtual strategies for obtaining abortion if they could not do so in Texas. Information about the safety and legality of options for abortion care and about financial and logistical-support resources could improve accessibility for those facing greater constraints.
STUDY DESIGN: In June and July 2022, we recruited Texans ≥ 18 years of age attending the mandatory consultation and ultrasound visit at 8 in-state facilities for a survey about their interest in strategies to obtain an abortion if they could not do so in Texas. We asked about five strategies: out-of-state facility-based care; abortion on a ship off Texas' coast; asynchronous non-US-based telehealth; synchronous US-based telehealth; or use of misoprostol from Mexico. We used 3-step latent class analysis to identify clusters (or classes) of abortion seekers with similar preferences and multinomial regression analysis to assess the relationship between resource constraints and class membership.
RESULTS: Among 293 respondents with complete information, we identified four classes: amenable to most strategies (n = 209), amenable to in-person strategies (n = 39), amenable to at-home strategies (n = 20), and few strategies acceptable (n = 25). Class membership was related to care preferences, access to a reliable car, and concern about the legality and safety of abortion pills obtained online.
CONCLUSIONS: Most respondents were interested in all strategies, while those with transportation barriers and abortion modality concerns found fewer strategies acceptable.
IMPLICATIONS: Most Texans seeking abortion were interested in a variety of in-person and virtual strategies for obtaining abortion if they could not do so in Texas. Information about the safety and legality of options for abortion care and about financial and logistical-support resources could improve accessibility for those facing greater constraints.