“I WORK WITH WHAT I HAVE”: MANAGING MEDICATION ABORTION AND MISCARRIAGE IN THE UNHOUSED COMMUNITY

Abstract

Objectives

We sought to provide better support to houseless individuals’ experiences with medication abortion.

Methods

We recruited pregnancy-capable persons from Sacramento between the ages of 18-55 who had experienced an abortion or miscarriage, were currently or previously unhoused, and spoke English. Fifteen, 30-minute interviews were conducted where participants were asked about their medication abortion or miscarriage experience, and how they would manage a medication abortion while unhoused given their experience. Inductive and deductive coding were utilized for theme development.

Results

Unmet needs fell into three main categories: (1) lack of access to a safe location to complete a medication abortion including hygiene facilities; (2) lack of social support including childcare and communication from their provider throughout and after the medication abortion; and (3) a lack of access to appropriate supplies including pain and bleeding management supplies.

Conclusions

Houseless individuals have specific experiences with medication abortion which lead to unique, and unmet, needs when compared with the general population of pregnancy-capable people. Public health providers can ensure patient-centered care by providing them with appropriate resources, such as social services and material goods, to navigate their abortion plan beyond the clinic. Next steps include offering these services and supplies to this population and assessing if the medication abortion experience is improved.