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Prenatal care utilization in pregnant women who consider but do not have abortions.
BMC Pregnancy Childbirth. 2022 Jan 21; 22(1):53.BP

Abstract

BACKGROUND

Over half of all pregnancies in the United States are unintended, and 18% result in termination of pregnancy (TOP). Some women seek TOP, but ultimately continue their pregnancy. Data are limited about their utilization of prenatal care and their perinatal outcomes. Our primary outcome was to investigate differences in guideline-based prenatal care utilization in women who consider but do not have an abortion.

METHODS

Retrospective cohort study of patients having obstetrical dating ultrasound (US) from 2011-2018 at a single academic medical center that offers TOP. Contemplators completed US with intention of TOP but instead continued the pregnancy to live birth. A 2:1 group of non-contemplators completed US and continued to live birth. A prenatal care utilization scoring system was used to compare groups. Secondary outcomes investigated differences in adverse pregnancy outcomes and postpartum care.

RESULTS

There were 94 contemplators and 183 non-contemplators. Inadequate prenatal care utilization initially was more common in contemplators than non-contemplators (62.8% vs 85.8%, p < 0.01) but was not significant after adjustment (aOR 1.0, 95% CI 0.40 - 2.56). There were no differences in adverse obstetric or neonatal outcomes. Contemplators were significantly more likely to have a postpartum contraceptive method (PPCM) upon hospital discharge (aOR 4.8, 95% CI 1.16 - 20.0) and significantly more likely to use a highly-effective PPCM (aOR 6.4, 95% CI 2.34 - 17.4).

CONCLUSIONS

Reversal of intention for TOP is not associated with differences in prenatal care utilization, but is associated with increased uptake of postpartum contraceptive method.

Links

PMC Free PDF

Authors+Show Affiliations

Toscano M
Department of Obstetrics & Gynecology, University of Rochester Medical Center, 601 Elmwood Ave, Box 668, Rochester, NY, 14642, USA. Marika_toscano@urmc.rochester.edu.
Wood J
Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
Spielman S
Department of Obstetrics & Gynecology, University of Rochester Medical Center, 601 Elmwood Ave, Box 668, Rochester, NY, 14642, USA.
Ferri R
School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA.
Whaley N
Department of Obstetrics & Gynecology, University of Rochester Medical Center, 601 Elmwood Ave, Box 668, Rochester, NY, 14642, USA.
Seligman NS
Department of Obstetrics & Gynecology, University of Rochester Medical Center, 601 Elmwood Ave, Box 668, Rochester, NY, 14642, USA.

MeSH

Abortion, InducedAdultContraception BehaviorFemaleHumansIntentionLive BirthNew YorkPatient Acceptance of Health CarePostnatal CarePregnancyPregnant WomenPrenatal CareRetrospective Studies

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

35062913

Citation

Toscano, Marika, et al. "Prenatal Care Utilization in Pregnant Women Who Consider but Do Not Have Abortions." BMC Pregnancy and Childbirth, vol. 22, no. 1, 2022, p. 53.
Toscano M, Wood J, Spielman S, et al. Prenatal care utilization in pregnant women who consider but do not have abortions. BMC Pregnancy Childbirth. 2022;22(1):53.
Toscano, M., Wood, J., Spielman, S., Ferri, R., Whaley, N., & Seligman, N. S. (2022). Prenatal care utilization in pregnant women who consider but do not have abortions. BMC Pregnancy and Childbirth, 22(1), 53. https://doi.org/10.1186/s12884-021-04343-x
Toscano M, et al. Prenatal Care Utilization in Pregnant Women Who Consider but Do Not Have Abortions. BMC Pregnancy Childbirth. 2022 Jan 21;22(1):53. PubMed PMID: 35062913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prenatal care utilization in pregnant women who consider but do not have abortions. AU - Toscano,Marika, AU - Wood,Jillian, AU - Spielman,Sara, AU - Ferri,Rita, AU - Whaley,Natalie, AU - Seligman,Neil S, Y1 - 2022/01/21/ PY - 2021/03/31/received PY - 2021/12/16/accepted PY - 2022/1/22/entrez PY - 2022/1/23/pubmed PY - 2022/2/9/medline KW - Postpartum contraception KW - Pregnancy ambivalence KW - Prenatal care utilization KW - Termination of pregnancy SP - 53 EP - 53 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 22 IS - 1 N2 - BACKGROUND: Over half of all pregnancies in the United States are unintended, and 18% result in termination of pregnancy (TOP). Some women seek TOP, but ultimately continue their pregnancy. Data are limited about their utilization of prenatal care and their perinatal outcomes. Our primary outcome was to investigate differences in guideline-based prenatal care utilization in women who consider but do not have an abortion. METHODS: Retrospective cohort study of patients having obstetrical dating ultrasound (US) from 2011-2018 at a single academic medical center that offers TOP. Contemplators completed US with intention of TOP but instead continued the pregnancy to live birth. A 2:1 group of non-contemplators completed US and continued to live birth. A prenatal care utilization scoring system was used to compare groups. Secondary outcomes investigated differences in adverse pregnancy outcomes and postpartum care. RESULTS: There were 94 contemplators and 183 non-contemplators. Inadequate prenatal care utilization initially was more common in contemplators than non-contemplators (62.8% vs 85.8%, p < 0.01) but was not significant after adjustment (aOR 1.0, 95% CI 0.40 - 2.56). There were no differences in adverse obstetric or neonatal outcomes. Contemplators were significantly more likely to have a postpartum contraceptive method (PPCM) upon hospital discharge (aOR 4.8, 95% CI 1.16 - 20.0) and significantly more likely to use a highly-effective PPCM (aOR 6.4, 95% CI 2.34 - 17.4). CONCLUSIONS: Reversal of intention for TOP is not associated with differences in prenatal care utilization, but is associated with increased uptake of postpartum contraceptive method. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/35062913/Prenatal_care_utilization_in_pregnant_women_who_consider_but_do_not_have_abortions_ DB - PRIME DP - Unbound Medicine ER -