Repeat abortion and use of primary care health services

Fam Plann Perspect. 1995 Jul-Aug;27(4):162-5.

Abstract

One-third (34%) of 2,001 women who sought an abortion in 1991-1992 in Wichita, Kansas, were repeat-abortion patients. Compared with first-time abortion patients, repeat-abortion patients were significantly older, more often black, and younger at their first pregnancy (p < .001). The two groups did not vary significantly by income or age at first intercourse. However, repeat-abortion patients were significantly more likely than first-time patients to have been using a contraceptive method at the time of conception (65% compared with 59%) and more likely to say they always or almost always used a method (63% and 53%, respectively). More than 40% of women in each group reported they had no personal physician. Further, 34% of repeat-abortion patients said they had no follow-up examination after their previous abortion, and 28% said they received no contraceptive counseling. Only half of women whose pregnancy was confirmed by their personal physician obtained an abortion referral from that physician.

PIP: To refine understanding of the characteristics of women who obtain a repeat abortion, the 2445 consecutive women who sought abortion at a Wichita, Kansas, clinic from July 1991 to June 1992 were administered a 100-item questionnaire prior to the procedure. 80% of abortion seekers were White and only 20% were currently married; the average age was 23.6 years. Of the 2001 women who completed the questionnaire, 23.7% had one prior abortion and another 10.5% had two or more prior abortions. Compared to women having their first abortion, repeat abortion patients were significantly older (22.5% vs. 25.7 years), more likely to be Black (8.5% vs. 16.1%), and more often married (17.4% vs. 22.8%). Of note were the high proportions of repeat abortion patients who were using a contraceptive method at the time of conception (65%) and were consistent users (63%); these rates were 59 and 53%, respectively, for first-time abortion patients. About 60% of women in both groups had a personal physician, and these women were significantly more likely than their counterparts with no regular source of care to be consistent users of contraception. On the other hand, only 10% of abortion patients were referred to the clinic by a primary care physician and the majority self-diagnosed their pregnancy or used a home-based test. 34% of repeat abortion patients had not received a follow-up examination in association with the prior abortion and 28% reported they were not given contraceptive counseling at that time. To reduce the need for repeat abortion, it is recommended that abortion clinic personnel ensure that all abortion patients without a primary care provider are referred to such a physician for ongoing comprehensive health care, including family planning.

Publication types

  • Multicenter Study

MeSH terms

  • Abortion Applicants* / psychology
  • Abortion, Induced / statistics & numerical data*
  • Adolescent
  • Adult
  • Age Factors
  • Chi-Square Distribution
  • Contraception Behavior
  • Ethnicity
  • Female
  • Humans
  • Kansas / epidemiology
  • Practice Patterns, Physicians'
  • Pregnancy
  • Primary Health Care / statistics & numerical data*
  • Social Class