Tsevat Danielle G, Bullington Brooke W, Arora Kavita S, Allison Bianca A
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; University of North Carolina Gillings School of Public Health, Chapel Hill, North Carolina.
University of North Carolina Gillings School of Public Health, Chapel Hill, North Carolina.
J Pediatr Adolesc Gynecol. 2025 Jun;38(3):414-418. doi: 10.1016/j.jpag.2024.12.004. Epub 2024 Dec 7.
To determine clinician factors associated with discussing abortion during pregnancy options counseling among adolescents.
We recruited and surveyed a convenience sample of US clinicians who care for pregnant adolescent patients (N = 146). Clinicians were recruited at a national conference, through listservs, and via a physician mailing list. We used chi-square tests to analyze differences in our primary outcomes (routinely discussing abortion, routinely providing abortion referrals, and not routinely advising patients seeking abortion against termination) by clinician demographics, beliefs, and practice settings.
Fifty-seven percent of clinicians reported routinely discussing abortion with adolescent patients, 58% routinely referred for abortion, and 76% did not routinely advise against termination. Female gender, pediatric specialty, and practicing in an academic setting were associated with routinely referring for abortion and not routinely counseling against abortion (P < .05). Additionally, state abortion laws at the time of the survey were associated with abortion discussion and referrals. Having "a personal objection to abortion" or "belief that abortion will harm patients" were negatively associated with each outcome (P < .05).
Clinician demographics and personal beliefs were associated with differences among counseling. Although this was a small exploratory study, our findings highlight important clinician-level barriers to adolescents' access to abortion counseling and care.
确定在为青少年提供孕期选择咨询时与讨论堕胎相关的临床医生因素。
我们招募并调查了一个方便样本的美国临床医生，这些医生负责照顾怀孕的青少年患者（N = 146）。临床医生是在一次全国性会议上、通过邮件列表以及医生邮件名单招募的。我们使用卡方检验来分析主要结果（常规讨论堕胎、常规提供堕胎转诊以及不常规建议寻求堕胎的患者不要终止妊娠）在临床医生的人口统计学特征、信念和执业环境方面的差异。
57%的临床医生报告称会与青少年患者常规讨论堕胎，58%会常规进行堕胎转诊，76%不会常规建议不要终止妊娠。女性、儿科专业以及在学术环境中执业与常规进行堕胎转诊和不常规提供反对堕胎的咨询相关（P < .05）。此外，调查时的州堕胎法律与堕胎讨论和转诊相关。“个人反对堕胎”或“认为堕胎会伤害患者”与每个结果均呈负相关（P < .05）。
临床医生的人口统计学特征和个人信念与咨询差异相关。尽管这是一项小型探索性研究，但我们的发现凸显了临床医生层面存在的、阻碍青少年获得堕胎咨询和护理的重要障碍。
