Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States

Natalie Morris; M Antonia Biggs; Finley Baba; Jane W Seymour; Kari White; Daniel Grossman

doi:10.1016/j.whi.2024.03.003

Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States

Womens Health Issues. 2024 Apr 23:S1049-3867(24)00023-9. doi: 10.1016/j.whi.2024.03.003. Online ahead of print.

Authors

Natalie Morris¹, M Antonia Biggs², Finley Baba², Jane W Seymour³, Kari White⁴, Daniel Grossman²

Affiliations

¹ Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California. Electronic address: Natalie.Morris@ucsf.edu.
² Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California.
³ Collaborative for Reproductive Equity, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
⁴ Resound Research for Reproductive Health, Austin, Texas.

PMID: 38658288
DOI: 10.1016/j.whi.2024.03.003

Abstract

Introduction: Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients' interest in these models.

Methods: Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.S. states to explore their interest in and support for advance provision, OTC, and online abortion access. We assessed relationships between sociodemographic characteristics and interest in and support for each model using bivariate logistic regressions and present perceived advantages and disadvantages of each model, as described by a subset of participants.

Results: Among 1,965 people enrolled, 1,759 (90%) initiated the survey. Interest in and support for advance provision was highest (72% and 82%, respectively), followed by OTC (63% and 72%) and online access (57% and 70%). In bivariate analyses, non-Hispanic Black and Asian/Pacific Islander respondents expressed lower interest and support for the online model and Alaska Native/Native American respondents expressed higher interest in an OTC model, as compared with white respondents. Among 439 participants naming advantages and disadvantages of each model, the most common advantages included convenience and having the abortion earlier. The most common disadvantages were not seeing a provider first and possibly taking pills incorrectly.

Conclusions: Although most abortion patients expressed interest in and support for alternative models of medication abortion provision, variation in support across race/ethnicity highlights a need to ensure that abortion care service models meet the needs and preferences of all patients, particularly people from historically underserved populations.