Prenatal care utilization in pregnant women who consider but do not have abortions

Toscano, Marika; Wood, Jillian; Spielman, Sara; Ferri, Rita; Whaley, Natalie; Seligman, Neil S.

Prenatal care utilization in pregnant women who consider but do not have abortions

Files

12884_2021_Article_4343.pdf (1.15 MB)

Authors

Toscano, Marika

Wood, Jillian

Spielman, Sara

Ferri, Rita

Whaley, Natalie

Seligman, Neil S.

Issue Date

2022-01-21

Type

Article

Language

en_US

Keywords

Prenatal Care Utilization , Termination of Pregnancy , Pregnancy Ambivalence , Postpartum Contraception

Abstract

Background: Over half of all pregnancies in the United States are unintended, and 18% result in termination of pregnancy (TOP). Some women seek TOP, but ultimately continue their pregnancy. Data are limited about their utilization of prenatal care and their perinatal outcomes. Our primary outcome was to investigate differences in guideline-based prenatal care utilization in women who consider but do not have an abortion. Methods: Retrospective cohort study of patients having obstetrical dating ultrasound (US) from 2011–2018 at a single academic medical center that offers TOP. Contemplators completed US with intention of TOP but instead continued the pregnancy to live birth. A 2:1 group of non-contemplators completed US and continued to live birth. A prenatal care utilization scoring system was used to compare groups. Secondary outcomes investigated differences in adverse pregnancy outcomes and postpartum care. Results: There were 94 contemplators and 183 non-contemplators. Inadequate prenatal care utilization initially was more common in contemplators than non-contemplators (62.8% vs 85.8%, p < 0.01) but was not significant after adjustment (aOR 1.0, 95% CI 0.40 – 2.56). There were no differences in adverse obstetric or neonatal outcomes. Contemplators were significantly more likely to have a postpartum contraceptive method (PPCM) upon hospital discharge (aOR 4.8, 95% CI 1.16 – 20.0) and significantly more likely to use a highly-effective PPCM (aOR 6.4, 95% CI 2.34 – 17.4). Conclusions: Reversal of intention for TOP is not associated with differences in prenatal care utilization, but is associated with increased uptake of postpartum contraceptive method.

Citation

Toscano, M., Wood, J., Spielman, S., Ferri, R., Whaley, N., & Seligman, N. S. (2022). Prenatal care utilization in pregnant women who consider but do not have abortions. BMC pregnancy and childbirth, 22(1), 53. https://doi.org/10.1186/s12884-021-04343-x

Publisher

BMC Pregnancy and Childbirth