Who seeks abortions at or after 20 weeks?

CONTEXT: Recent years have seen the introduction of state bills seeking to ban abortions after 20 weeks, but little empirical data exist on who is affected when such bans become law.

METHODS: As part of a larger study, 272 women who received an abortion at or after 20 weeks' gestation and 169 who received first-trimester abortions at 16 facilities across the country in 2008-2010 were interviewed one week after the procedure. Mixed effect logistic regression analyses were used to determine the characteristics associated with later abortion (i.e., at 20 weeks or later). Causes of delay in obtaining abortion were assessed in open- and closed-ended questions; profiles of women who received later abortions were identified through factor analysis.

RESULTS: Women aged 20-24 were more likely than those aged 25-34 to have a later abortion (odds ratio, 2.7), and women who discovered their pregnancy before eight weeks' gestation were less likely than others to do so (0.1). Later abortion recipients experienced logistical delays (e.g., difficulty finding a provider and raising funds for the procedure and travel costs), which compounded other delays in receiving care. Most women seeking later abortion fit at least one of five profiles: They were raising children alone, were depressed or using illicit substances, were in conflict with a male partner or experiencing domestic violence, had trouble deciding and then had access problems, or were young and nulliparous.

CONCLUSION: Bans on abortion after 20 weeks will disproportionately affect young women and women with limited financial resources.