Predictors of pregnancy options counseling and abortion referrals or dissuasion among United States primary care physicians: results from a national survey

Counseling college students after a positive pregnancy test: Trends in practice

Objective: To provide an overview of college health centers' practices surrounding education, counseling and referral after a patient receives a positive pregnancy test. Participants: College health centers that participated in the annual ACHA Pap Test and STI Survey years 2008 to 2014. Methods: Descriptive analyses for items regarding all-options and limited counseling/education and types of referrals (adoption, abortion and prenatal care) provided to students. Chi-square statistics were calculated to examine trends over time and differences between demographic characteristics. Results: There were no significant differences across time but there were significant differences between regions of the US and if the institution was faith-based, though few had strong association values. Conclusions: The results indicate most college health centers are following best practices regarding counseling and education for a positive pregnancy test result. Understanding limitations for those institutions not in compliance require further exploration.

Abortion Referral Practices among a National Sample of Obstetrician-Gynecologists

BACKGROUND

Obstetrician-gynecologists (ob-gyns) play a critical role in improving access to timely abortion care. This cross-sectional study estimates the proportion of ob-gyns providing abortion referral in the prior year and identifies predictors of direct (facilitated) referral compared with indirect referral (providing contact information).

METHODS

In 2016-2017, we invited a national sample of 2,500 ob-gyns to complete a survey. We restricted the final sample of 1,280 respondents (52% response rate) to participants who had abortion-seeking patients in the last 12 months (n = 868, 68% of the sample). We calculated descriptive statistics by referral type and conducted logistic regression analyses to examine associations between physician and practice setting characteristics and abortion referral type (direct vs. indirect).

RESULTS

Eighty-eight percent of ob-gyns provided abortion referral (479 [55%] indirect referrals; 287 [33%] direct referrals). Abortion provision in the prior year (adjusted odds ratio, 2.82; 95% confidence interval, 1.80-4.42) was a significant predictor of direct referrals. Compared with ob-gyns practicing in the Northeast, ob-gyns in the South had lower odds of direct referrals (adjusted odds ratio, 0.39; 95% confidence interval, 0.24-0.62), whereas those in the West had higher odds (adjusted odds ratio, 1.91; 95% confidence interval, 1.14-3.23). Ob-gyns providing direct referrals were more likely to practice within 25 miles of an abortion facility compared with those who provided indirect referrals (25% vs. 5%, respectively; p < .001).

CONCLUSIONS

Although the majority of ob-gyns refer patients for abortion care, most offer indirect referrals, only providing contact information for an abortion provider. Ob-gyns should facilitate referrals as access becomes more constrained, especially in regions where abortion facilities are limited.