The impact of intimate partner violence on abortion type choice
Awarded 2021
Complex Family Planning Fellowship Research
Lauren Sobel, DO, MPH
Brigham and Women's Hospital

Lifetime intimate partner violence (IPV) among individuals seeking abortion is estimated to be between 26% and 39%. The economic and psychosocial stressors associated with COVID-19 mandatory lockdowns have resulted in increased IPV. The prevalence of medication abortion has increased over the past decade, while surgical abortion has decreased. Yet individuals who are not safe at home may elect office-based surgical abortion procedures.

Our primary objective is to assess the relationship between IPV in the past 12 months (recent IPV) and choice of medication or surgical abortion among individuals seeking abortion at less than 11 weeks gestation. We hypothesize that individuals with a history of recent IPV will elect medication abortion less often than those without. We will secondarily assess the impact of the COVID-19 pandemic on abortion method choice and acceptability of pre-abortion telehealth IPV screening.
We will recruit 388 individuals seeking abortion care at Planned Parenthood League of Massachusetts to participate in a cross-sectional survey. We will assess IPV exposure using a modified Abuse Assessment Screen and abortion method chosen though participant self-report. We will assess our secondary objectives though open-ended questions. For our primary analysis we will use a multivariate logistic regression to estimate the effect of IPV on abortion type chosen adjusting for potential confounders.

An understanding of the abortion services needed by pregnancy capable individuals with a history of IPV is paramount to ensuring safe abortion access for this vulnerable population. These data will also lay a foundation for best practices for telehealth IPV screening.