Do women tell their contraceptive care providers about when they have abortions?
Awarded 2012
Trainee Grants
Lisa An, BA
Yale University

Objectives: When contraceptive and abortion care are separated, women having abortions may not tell their separate contraceptive provider about their method failure and abortion. We examined abortion disclosure rates to contraceptive providers, reasons for abortion nondisclosure, and factors associated with disclosure. Study Design: We conducted a voluntary, anonymous, self-administered survey of 202 women seeking medical or surgical abortion from Planned Parenthood of Southern New England to determine abortion disclosure rates to their contraceptive providers. We also collected demographics, reproductive health history, and contraceptive provider characteristics. We calculated descriptive statistics and logistical regression modeling around disclosure of abortion. We defined obstetrical/gynecological providers as private practice physicians or mid level providers who specialize in women’s health, such as certified nurse midwives, excluding providers who work at Planned Parenthood. Non obstetrical/gynecological providers are defined as any other type of medical provider, including primary care physicians, pediatricians, or other non-women’s health focused mid level providers. Results: Almost half of women (44%) did not disclose their abortion to their contraceptive providers. The most common reasons for nondisclosure of the abortion were “I don’t want them to know I’m having an abortion” (44%), “I’m changing providers” (20%), embarrassment about the pregnancy (14%), and fear of judgment (14%). Compared to Planned Parenthood contraceptive providers, women were significantly less likely to disclose to an obstetrical/gynecological provider outside of the Planned Parenthood system (adjusted OR 0.28, 95% CI 0.10-0.75) and to a non-obstetrical/gynecologic provider (adjusted OR 0.10, 95% CI 0.02?0.42). Age, race/ethnicity, income, and education were not significantly associated with abortion disclosure. Conclusion(s): We found that only provider type was significantly associated with disclosure, while intrinsic characteristics of the women were not. This suggests that abortion stigma is pervasive and affects women from many walks of life. Implications: It is concerning that abortion stigma may be a significant factor compromising effective contraceptive counseling and patient/provider relationships.