Investigating women’s experiences and clinical outcomes of advanced abortion
Awarded 2017
Large Research Grants
Katrina Kimport, PhD
University of California, San Francisco

Objectives: The idea of third-trimester abortion has been used politically, both to cultivate support for and opposition to abortion rights but the experiences of people who obtain such abortions is missing from public discourse. This study aimed to: 1) increase knowledge of women’s experience of seeking and obtaining third-trimester abortion and 2) document relevant clinical practices. Methods: For Aim 1, we conducted 28 in-depth phone interviews with women who had obtained a third-trimester abortion. For Aim 2, we conducted key informant interviews with providers and chart review of third-trimester patients at an outpatient clinic that provides third-trimester abortion care. Results: Women find themselves seeking an abortion after the 24th week of pregnancy via two pathways: 1) they received new information about the pregnancy after the 24th week; and 2) they sought an earlier abortion but faced significant barriers to care, which pushed them into the third trimester. The distinction between these pathways is blurry, with some receiving new information then facing significant legal and institutional barriers to care and some who sought an earlier abortion likely having an undiagnosed fetal health issue. Documentation of the clinical practices of third-trimester outpatient medication abortion demonstrates its safety. Conclusion: Women who seek and obtain third-trimester abortions have a particular but not fundamentally unique experience, largely owing to the marginalization of third-trimester abortion care in specific. Documentation of safe later abortion practices can have global applications for use in low-resourced settings.