Population-level research on trends in medication abortions and the association of patient characteristics and facility type with procedure choice is limited. Surveillance is necessary to ensure accurate reporting and understanding of service availability.
New York City induced abortion data for 2001–2008 were used to calculate medication abortion prevalence among women undergoing early abortions (i.e., at nine or fewer weeks of gestation). Multiple logistic regression analysis was used to assess associations between selected characteristics and having a medication, as opposed to surgical, abortion. Proportions of patients who went to clinics or hospitals that did not offer medication abortions were also calculated.
Five percent of early abortions were medication procedures in 2001; the proportion rose to 13% by 2008. Eighty-two percent of medication abortions in 2008 were performed at freestanding clinics, and 10% at doctors’ offices. The likelihood of having had a medication abortion, rather than a surgical one, was lower among blacks and Hispanics than among whites (odds ratios, 0.5 and 0.7, respectively). Medication abortions were more likely among women with more than 12 years of education than among those with less than a high school education (2.1), and more likely among those who went to doctors’ offices than among clinic patients (3.6). Throughout 2001–2008, medication abortions were not available at 50% of hospitals and 31% of clinics that provided early abortions.
The increasing prevalence of medication abortions highlights the importance of active surveillance. Because many facilities do not offer the procedure, a better understanding of barriers to provision is needed.
Cristina Yunzal-Butler is research scientist, and Judith Sackoff is director of Research and Evaluation, both at the Bureau of Maternal, Infant and Reproductive Health. Wenhui Li is director of Statistical Analysis and Reporting, Bureau of Vital Statistics—all at the New York City Department of Health and Mental Hygiene.