Financial Barriers Are Associated With Self-Managed Abortion in Indiana: Results From a Mixed-Methods Study in 2021-2022.

IF 3.4 2区医学 Q1 DEMOGRAPHY

Perspectives on Sexual and Reproductive Health Pub Date : 2025-04-04 DOI:10.1111/psrh.70008

Heidi Moseson, Caitlin McKenna, Bria Goode, Alexandra Wollum, Meg Sasse Stern, Tracey A Wilkinson

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引用次数: 0

Abstract

Objectives: To measure knowledge of and experiences with self-managed abortion among abortion seekers in Indiana before the Supreme Court decision in Dobbs v. Jackson Women's Health Organization (Dobbs).

Study design: Between June 2021 and April 2022, we recruited a non-probability sample of Indiana residents of any age who were currently or recently pregnant and considering abortion via online advertisements, referrals from abortion funds, and flyers in abortion clinics. Participants completed two online surveys 1 month apart, and a subset completed in-depth interviews. We conducted descriptive and regression analyses of characteristics, methods, motivations, and knowledge of self-managed abortion.

Results: Among 434 total participants, 33 (7.6%, 95% CI: 5.5%-10.5%) reported a self-managed abortion attempt for their current/recent pregnancy; these participants were younger, less likely to be parents, more likely to be pregnant for the first time, and more likely to identify as a sexual and/or gender minority person than were participants who did not attempt to self-manage. Participants cited unaffordability of clinician-supported abortion care (n = 16/33, 49%) as the most common reason for attempting to self-manage. Those who reported challenges paying for abortion were three times more likely to attempt a self-managed abortion than those who did not (aRR: 3.0, 95% CI: 1.1, 8.2). Interviews (n = 40) highlighted low awareness of self-managed medication abortion.

Conclusions: Among people who faced financial barriers to clinician-supported abortion care in Indiana, financial distress motivated some residents to self-manage abortions. In the further restricted post-Dobbs period, financial support to obtain clinician-supported care and trusted, accessible information on safe and effective self-managed abortion options are imperative so that Indiana residents can access abortion care in accordance with their preferences.

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印第安纳州经济障碍与自我管理堕胎相关：2021-2022年混合方法研究结果

目的：在最高法院Dobbs诉杰克逊妇女健康组织（Dobbs）案判决之前，衡量印第安纳州寻求堕胎者对自我管理堕胎的知识和经验。研究设计：在2021年6月至2022年4月期间，我们通过在线广告、堕胎基金推荐和堕胎诊所传单，招募了印第安纳州任何年龄的、目前或最近怀孕并考虑堕胎的居民的非概率样本。参与者间隔1个月完成两次在线调查，一部分人完成深度访谈。我们对自我管理流产的特征、方法、动机和知识进行了描述性和回归分析。结果：在434名参与者中，33名（7.6%,95% CI: 5.5%-10.5%）报告了他们当前或最近怀孕的自我管理流产企图；与没有尝试自我管理的参与者相比，这些参与者更年轻，更不可能为人父母，更有可能第一次怀孕，更有可能被认定为性和/或性别少数群体。参与者引用无法负担临床医生支持的堕胎护理（n = 16/33, 49%）作为试图自我管理的最常见原因。那些报告难以支付堕胎费用的人尝试自我管理堕胎的可能性是那些没有报告的人的三倍（aRR: 3.0, 95% CI: 1.1, 8.2）。访谈（n = 40）强调对自我管理药物流产的认识较低。结论：在印第安纳州面临经济障碍的临床支持堕胎护理的人群中，经济困境促使一些居民自我管理堕胎。在后多布斯时期，为获得临床支持的护理和安全有效的自我管理堕胎选择的可信、可获得的信息提供财政支持是必要的，这样印第安纳州的居民才能根据自己的喜好获得堕胎护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perspectives on Sexual and Reproductive Health Multiple-

CiteScore

5.10

自引率

3.40%

发文量

期刊介绍： Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.