Office of Population Research, Princeton University, 218 Wallace Hall, Princeton, NJ 08544.
Department of Sociology, Anthropology, and Social Work, Texas Tech University.
Contraception. 2018 Sep;98(3):237-242. doi: 10.1016/j.contraception.2018.05.013. Epub 2018 May 18.
The most effective forms of emergency contraception (EC) require a prescription or a medical procedure; therefore, provider willingness to offer EC remains critical to patient access. This study seeks to assess whether political alignment of a provider's county is associated with provider attitudes and behaviors regarding EC.
We analyzed survey data collected from 1313 healthcare providers from February 2013 to April 2014 at 14 academic medical centers in the United States. Using logistic regression, we estimated associations between the county political alignment of a provider's practice and his or her EC-related beliefs and practices: 1) if the provider is aware of the most effective EC methods; 2) if knowing that a hypothetical EC method prevented implantation would make a provider less likely to prescribe that method because of personal ethical or religious reasons; and 3) if the provider prescribes any form of EC in his or her practice.
In multivariate models, a one percentage-point increase in county Republican vote share was associated with a 2.9% decrease in the odds of a provider prescribing EC, after accounting for provider knowledge and attitudes about EC.
EC provides a critical last chance to prevent pregnancy after unprotected sex, yet women living in Republican-leaning counties may face difficulty obtaining EC from healthcare providers. Programs seeking to improve access to EC should focus on areas likely to have fewer providers willing to prescribe EC, which may be those that are more Republican-leaning.
The most effective forms of emergency contraception require a prescription or a medical procedure; therefore, provider willingness to offer EC remains critical to patient access. Women living in Republican-leaning counties may face difficulty obtaining emergency contraception from healthcare providers.
最有效的紧急避孕（EC）形式需要处方或医疗程序；因此，提供者提供 EC 的意愿仍然对患者获得 EC 至关重要。本研究旨在评估提供者所在县的政治立场是否与提供者对 EC 的态度和行为有关。
我们分析了 2013 年 2 月至 2014 年 4 月在美国 14 家学术医疗中心从 1313 名医疗保健提供者收集的调查数据。使用逻辑回归，我们估计了提供者实践所在县的政治立场与他或她的 EC 相关信念和实践之间的关联：1）提供者是否了解最有效的 EC 方法；2）如果知道一种假设的 EC 方法因个人伦理或宗教原因而阻止着床，是否会使提供者不太可能开这种方法；3）提供者是否在其实践中开任何形式的 EC。
在多变量模型中，在考虑到提供者对 EC 的知识和态度后，县共和党选票份额每增加一个百分点，提供者开 EC 的几率就会降低 2.9%。
EC 是在无保护性行为后防止怀孕的最后一个关键机会，但居住在共和党倾向县的女性可能难以从医疗保健提供者那里获得 EC。旨在改善 EC 获得途径的计划应侧重于那些不太愿意开 EC 的提供者可能较少的地区，这些地区可能更倾向于共和党。
最有效的紧急避孕形式需要处方或医疗程序；因此，提供者提供 EC 的意愿仍然对患者获得 EC 至关重要。居住在共和党倾向县的女性可能难以从医疗保健提供者那里获得紧急避孕。
