The impact of lifetime intimate partner violence on abortion method choice

Abstract

Objective(s)

To evaluate if the type of abortion patients prefer differs for those with a history of intimate partner violence (IPV) compared to those without a history of IPV.

Study design

We compared choice of medication versus procedural abortion between those with a history of lifetime IPV and those without a history of IPV among patients seeking abortion at 11 weeks’ gestation or less. Secondarily, we compared preferred abortion characteristics and assessed reproductive autonomy. Individuals presenting for abortion care were recruited for an anonymous, cross-sectional survey study at Planned Parenthood League of Massachusetts, Boston Health Center from September 2021 to August 2022. We required 336 subjects to detect a 20% difference in abortion method between those with a lifetime history of IPV and those without, with 80% power.

Results

We enrolled 342 participants and excluded six with missing data. A total of 71 individuals (21%) reported a lifetime history of IPV. A majority of individuals with a lifetime history of IPV chose procedural abortion, although their abortion method choice did not differ significantly from individuals with no history of IPV (56.3% vs 47.2%, p = 0.244). Individuals with a lifetime IPV history used abortion funds more frequently than those without a history of lifetime IPV (8.5% vs 1.5%, p = 0.047). There was no statistical difference between individuals with and without a lifetime history of IPV regarding what individuals considered important for the type of abortion they chose or reproductive autonomy.

Conclusion(s)

Access to procedural abortion services and abortion funds are important to meet the abortion needs of patients with a lifetime history of IPV.

Implications

Providing both medication and procedural abortion and creating a trauma-informed environment are central to supporting individuals with a history of IPV. Safeguarding abortion fund access is important individuals with a history of IPV.