Abortion method preference among people presenting for abortion care

ABSTRACT Objective To explore abortion method preference, interpersonal and cultural factors associated with preference, and whether, among people with a preference for medication abortion, those presenting past 10 weeks gestation had experienced more obstacles to care. Methods In 2019, we invited people aged 15 to 45 years presenting to 4 U.S. abortion clinics to complete a self-administered, anonymous iPad survey prior to seeing the health care provider. Questions focused on their pregnancy, including self-reported gestational age and experiences accessing abortion care, including abortion method preference. We used multivariate logistic regression to assess associations between worry about perceived pregnancy-related stigma or abortion-related health myths and abortion method preference. Results The majority (784 [77%]) of those approached (1092) initiated the survey and 712 responded to the preference question. Most (597 [84%]) preferred a method: 246 (41%) preferred medication abortion and 351 (59%) an in-clinic procedure. About one-third (110 [32%]) of those preferring medication abortions exceeded 10 weeks gestation and 83% (n = 91) had experienced delay-causing obstacles to care. In multivariate analyses, we found a greater odd of preference for medication abortion over in-clinic procedure among those very worried about people's reaction to the pregnancy (adjusted OR [aOR] 1.95, 95% CI 1.16–3.28), judgment from God or religion (aOR 1.93, 95% CI 1.17–3.19) and abortion affecting mental health (aOR 2.51, 95% CI 1.45–4.34) or ability to get pregnant later (aOR 1.80, 95% CI: 1.09–2.97). Conclusions Many people seeking abortion have a method preference; delayed presentation to care may impede ability to obtain desired method. Pregnancy-related stigma and misinformation are associated with preference for medication abortion.