Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California.
Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California.
Womens Health Issues. 2024 Jul-Aug;34(4):381-390. doi: 10.1016/j.whi.2024.03.003. Epub 2024 Apr 23.
Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients' interest in these models.
Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.S. states to explore their interest in and support for advance provision, OTC, and online abortion access. We assessed relationships between sociodemographic characteristics and interest in and support for each model using bivariate logistic regressions and present perceived advantages and disadvantages of each model, as described by a subset of participants.
Among 1,965 people enrolled, 1,759 (90%) initiated the survey. Interest in and support for advance provision was highest (72% and 82%, respectively), followed by OTC (63% and 72%) and online access (57% and 70%). In bivariate analyses, non-Hispanic Black and Asian/Pacific Islander respondents expressed lower interest and support for the online model and Alaska Native/Native American respondents expressed higher interest in an OTC model, as compared with white respondents. Among 439 participants naming advantages and disadvantages of each model, the most common advantages included convenience and having the abortion earlier. The most common disadvantages were not seeing a provider first and possibly taking pills incorrectly.
Although most abortion patients expressed interest in and support for alternative models of medication abortion provision, variation in support across race/ethnicity highlights a need to ensure that abortion care service models meet the needs and preferences of all patients, particularly people from historically underserved populations.
药物流产是安全有效的，但限制仍然限制了患者获得这种方法的机会。药物流产提供的替代模式，即预先提供、非处方（OTC）和在线提供，可能有助于改善一些人的护理机会，尽管关于堕胎患者对这些模式的兴趣的证据有限。
在 2017 年至 2019 年期间，我们在美国 15 个州的 45 个诊所对堕胎患者进行了横断面调查，以探讨他们对预先提供、OTC 和在线堕胎机会的兴趣和支持。我们使用双变量逻辑回归评估了社会人口统计学特征与对每种模式的兴趣和支持之间的关系，并介绍了一部分参与者对每种模式的感知优势和劣势。
在 1965 名入组者中，有 1759 人（90%）开始了调查。对预先提供的兴趣和支持最高（分别为 72%和 82%），其次是 OTC（63%和 72%）和在线访问（57%和 70%）。在双变量分析中，与白人受访者相比，非西班牙裔黑人和亚洲/太平洋岛民受访者对在线模式的兴趣和支持较低，而阿拉斯加原住民/美洲原住民受访者对 OTC 模式的兴趣较高。在 439 名参与者中，有 439 名参与者提到了每种模式的优缺点，最常见的优点包括方便和更早地进行堕胎。最常见的缺点是不首先看医生，并且可能不正确地服用药物。
尽管大多数堕胎患者对药物流产提供的替代模式表示有兴趣和支持，但不同种族/族裔之间的支持差异突出表明，需要确保堕胎护理服务模式满足所有患者的需求和偏好，特别是那些历史上服务不足的人群。
