Feelings about abortion at time of care: Findings from an Ohio abortion facility.

Introduction: Prevailing abortion stigma may contribute to how people feel prior to receiving an abortion, and these feelings may influence healthcare decision making. We analyzed data from a patient intake questionnaire regarding feelings at the time of first abortion appointment. We described responses, co-occurrence of sentiments, and associations between responses and abortion characteristics.

Methods: We abstracted data from a random 20% sample of medical charts at an abortion facility in Ohio for patients who sought abortions from 2014-2018 (N=762). We analyzed data from an intake questionnaire used to assess patients' sentiments prior to their abortion. The questionnaire had 10 intake items to which patients could respond "yes," "maybe," or "no." The questionnaire also asked, "How are you feeling today?" and listed several emotions for patients to select.

Results: About 37% of patients responded with exclusively positive emotions, 27% with mixed emotions, and 27% with exclusively negative emotions. Reporting mixed (adjusted odds ratio [95%CI]: 0.33[0.16-0.71]) and negative only (0.38[0.18-0.32]) sentiments was associated with a decreased odds of receiving an abortion. Responding "yes" (vs. "no") to being afraid an abortion will hurt was associated with a decreased odds of having a procedural abortion vs. a medication abortion (0.62[0.40-0.96]). Responding "yes" to "I am not sure if I am making the right decision" was associated with a longer time between consultation and the abortion (adjusted incident rate ratio [95%CI]: 2.16[1.48-3.16]).

Conclusions: Sentiment toward abortion is complicated and deserves nuanced attention, rather than being grouped into a strictly positive or negative experience.

Policy implications: Assessing patient sentiment prior to an abortion procedure may be valuable for providing patient-centered abortion care.