Objective(s)

To compare the characteristics of people obtaining medication and procedural abortions in clinical settings in the United States.

Study design

We conducted a cross-sectional survey of people obtaining abortions at a sample of 56 US facilities between June 2021–July 2022. We restricted analyses to patients with pregnancies less than 11 weeks’ gestation presenting at 43 clinics offering both medication and procedural abortion. We conducted bivariate analyses and multivariable logistic regression to identify factors associated with obtaining a medication versus procedural abortion.

Results

Our analytic sample includes 4,717 respondents, 57% of whom obtained a medication abortion. In bivariate analyses, individuals who identified as Asian or white, had no prior births or abortions, or were paying out of pocket were all more likely to have a medication abortion. Non-Hispanic Black individuals, those with incomes at or below the poverty-level, and those paying with insurance were more likely to have a procedural abortion. Some 24% of respondents chose the facility because it offered medication abortion, but even after controlling for this proxy for method preference in a logistic regression model, Black respondents and those with poverty-level incomes were less likely to have a medication abortion.

Conclusion

Findings suggest that Black individuals and those with low incomes—who often face systemic barriers to care—are less likely to have medication abortions. When medication abortion is the only option available, for example at a medication-only clinic or from an online source, these groups may be most impacted by the lack of options.

Implications

To the extent possible, offering both medication and procedural abortion, and increasing access to both types, are important to meet patients’ individual needs and preferences.