Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA.
Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA; Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA.
Sex Reprod Healthc. 2024 Mar;39:100932. doi: 10.1016/j.srhc.2023.100932. Epub 2023 Nov 25.
To determine whether trust in the provider and sociodemographics are associated with individual-level abortion stigma.
We performed a cross sectional and exploratory study design using secondary analysis of a randomized trial that enrolled participants undergoing second trimester abortion. We collected baseline survey data from 70 trial participants to assess stigma (Individual Level of Abortion Stigma scale, ILAS; range 0-4), trust in provider (Trust in Physician scale; range 1-5), anxiety, depression, and sociodemographics. We performed multiple linear regression, for which ILAS score was the outcome of interest. Univariate associations were used to inform the regression model.
The mean abortion stigma score was at the low end of the ILAS at 1.21 (range 0.2-2.8, SD 0.66). Age, race, income, BMI, parity, gestational age at time of abortion, and reasons for ending the pregnancy were not significantly associated with the ILAS score. Higher trust in provider scores were (m 4.0, SD 0.49) and inversely related to the ILAS score, even after adjustment for confounders (β -0.02, CI -0.03 to -0.004, p = 0.013). Screening positive for anxiety or depression was associated with a higher ILAS score ((β 0.48, CI 0.10, 0.90, p = 0.015); (β = 0.27 CI -0.097, 0.643)), while cohabitation was associated with lower ILAS score (β -0.44, CI -0.82 to -0.57, p = 0.025).
Trust in an abortion provider, anxiety, depression, and cohabitation are associated with abortion stigma among people seeking second trimester abortion care. Interventions that improve trust in a provider may be an area of focus for addressing abortion stigma. Future research should confirm these findings in larger populations and across diverse locations and demographics and to conduct qualitative research to understand what patients perceive as trust-promoting behaviors and words during abortion encounters.
确定对提供者的信任和社会人口统计学因素是否与个体层面的堕胎耻辱感相关。
我们采用二次分析一项随机试验的横断面和探索性研究设计，该试验招募了接受中期堕胎的参与者。我们从 70 名试验参与者那里收集了基线调查数据，以评估耻辱感（个体层面堕胎耻辱感量表，ILAS；范围 0-4）、对提供者的信任（信任医生量表；范围 1-5）、焦虑、抑郁和社会人口统计学因素。我们进行了多元线性回归，其中 ILAS 评分是感兴趣的结果。单变量关联用于为回归模型提供信息。
平均堕胎耻辱感评分处于 ILAS 的低端，为 1.21（范围 0.2-2.8，SD 0.66）。年龄、种族、收入、BMI、产次、堕胎时的孕龄以及终止妊娠的原因与 ILAS 评分无显著相关性。提供者的信任评分较高（m 4.0，SD 0.49），与 ILAS 评分呈负相关，即使在调整混杂因素后也是如此（β-0.02，CI-0.03 至-0.004，p=0.013）。焦虑或抑郁筛查阳性与较高的 ILAS 评分相关（（β 0.48，CI 0.10，0.90，p=0.015）；（β=0.27 CI-0.097，0.643）），而同居与较低的 ILAS 评分相关（β-0.44，CI-0.82 至-0.57，p=0.025）。
对堕胎提供者的信任、焦虑、抑郁和同居与寻求中期堕胎护理的人堕胎耻辱感相关。提高对提供者信任的干预措施可能是解决堕胎耻辱感的一个重点领域。未来的研究应在更大的人群中以及在不同的地点和人口统计学特征中确认这些发现，并进行定性研究，以了解患者在堕胎过程中认为哪些行为和言语是值得信任的。
