Evaluating the impact of a mandatory pre-abortion ultrasound viewing law: A mixed methods study

被引:23
作者
Upadhyay, Ushma D. [1 ]
Kimport, Katrina [1 ]
Belusa, Elise K. O. [1 ]
Johns, Nicole E. [1 ]
Laube, Douglas W. [2 ]
Roberts, Sarah C. M. [1 ]
机构
[1] Univ Calif San Francisco, Adv New Stand Reprod Hlth ANSIRH, Bixby Ctr Global Reprod Hlth, Dept Obstet Gynecol & Reprod Sci, Oakland, CA 94143 USA
[2] Univ Wisconsin, Sch Med & Publ Hlth, Obstet & Gynecol, Madison, WI USA
来源
PLOS ONE | 2017年 / 12卷 / 07期
关键词
INTERRUPTED TIME-SERIES; FEDERATION MEMBERS; IMAGE; CARE; HEALTH; WOMEN;
D O I
10.1371/journal.pone.0178871
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Since mid-2013, Wisconsin abortion providers have been legally required to display and describe pre-abortion ultrasound images. We aimed to understand the impact of this law. Methods We used a mixed-methods study design at an abortion facility in Wisconsin. We abstracted data from medical charts one year before the law to one year after and used multivariable models, mediation/moderation analysis, and interrupted time series to assess the impact of the law, viewing, and decision certainty on likelihood of continuing the pregnancy. We conducted in-depth interviews with women in the post-law period about their ultrasound experience and analyzed them using elaborative and modified grounded theory. Results A total of 5342 charts were abstracted; 8.7% continued their pregnancies pre-law and 11.2% post-law (p = 0.002). A multivariable model confirmed the law was associated with higher odds of continuing pregnancy (aOR = 1.23, 95% CI: 1.01-1.50). Decision certainty (aOR = 6.39, 95% CI: 4.72-8.64) and having to pay fully out of pocket (aOR = 4.98, 95% CI: 3.86-6.41) were most strongly associated with continuing pregnancy. Ultrasound viewing fully mediated the relationship between the law and continuing pregnancy. Interrupted time series analyses found no significant effect of the law but may have been underpowered to detect such a small effect. Nineteen of twenty-three women interviewed viewed their ultrasound image. Most reported no impact on their abortion decision; five reported a temporary emotional impact or increased certainty about choosing abortion. Two women reported that viewing helped them decide to continue the pregnancy; both also described preexisting decision uncertainty. Conclusions This law caused an increase in viewing rates and a statistically significant but small increase in continuing pregnancy rates. However, the majority of women were certain of their abortion decision and the law did not change their decision. Other factors were more significant in women's decision-making, suggesting evaluations of restrictive laws should take account of the broader social environment.
引用
收藏
页数:23
相关论文
共 50 条
[41]   Indigenous Australians' participation in pre-registration tertiary nursing courses: A mixed methods study [J].
West, Roianne ;
Usher, Kim ;
Buettner, Petra G. ;
Foster, Kim ;
Stewart, Lee .
CONTEMPORARY NURSE, 2013, 46 (01) :123-134
[42]   Sexual and Reproductive Health Literacy, Misoprostol Knowledge and Use of Medication Abortion in Lagos State, Nigeria: A Mixed Methods Study [J].
Vaisanen, Heini ;
Moore, Ann M. ;
Owolabi, Onikepe ;
Stillman, Melissa ;
Fatusi, Adesegun ;
Akinyemi, Akanni .
STUDIES IN FAMILY PLANNING, 2021, 52 (02) :217-237
[43]   Accuracy of gestational age estimation from last menstrual period among women seeking abortion in South Africa, with a view to task sharing: a mixed methods study [J].
Constant, Deborah ;
Harries, Jane ;
Moodley, Jennifer ;
Myer, Landon .
REPRODUCTIVE HEALTH, 2017, 14
[44]   Remote Monitoring of Psoriasis: Comparing Care Models and Evaluating Quality of Life Outcomes: Mixed Methods Study [J].
Arsenjeva, Jana ;
Kruus, Priit ;
Hallik, Riina ;
Matasova, Secil ;
Prett, Laura ;
Kaarna, Katrin ;
Raam, Liisi ;
Taul, Oliver ;
Ilves, Liis ;
Viljar, Kaisa ;
Konno, Pille ;
Ross, Peeter ;
Kingo, Kulli .
JOURNAL OF MEDICAL INTERNET RESEARCH, 2025, 27
[45]   "Sick or not sick?" A mixed methods study evaluating the rapid determination of illness severity in a pediatric emergency department [J].
O'Neill, Laura B. ;
Bhansali, Priti ;
Bost, James E. ;
Chamberlain, James M. ;
Ottolini, Mary C. .
DIAGNOSIS, 2022, 9 (02) :207-215
[46]   Evaluating an embodied mindfulness approach to teach reflective practice to MSW students: a mixed methods case study [J].
Katz, Ellen ;
Kirvan, Anne ;
Tufford, Lea ;
Bogo, Marion .
SOCIAL WORK EDUCATION, 2024, 43 (04) :938-955
[47]   Sexual Enrichment Aids: A Mixed Methods Study Evaluating Use, Hygiene, and Risk Perception among Women [J].
Collar, Amanda L. ;
Fuentes, Jesus E. ;
Brakey, Heidi Rishel ;
Frietze, Kathryn M. .
JOURNAL OF SEX RESEARCH, 2022, 59 (09) :1153-1162
[48]   Pre-Exposure Prophylaxis Integration into Family Planning Services at Title X Clinics in the Southeastern United States: A Geographically-Targeted Mixed Methods Study (Phase 1 ATN 155) [J].
Sales, Jessica M. ;
Escoffery, Cam ;
Hussen, Sophia A. ;
Haddad, Lisa B. ;
Phillips, Ashley ;
Filipowicz, Teresa ;
Sanchez, Maria ;
McCumber, Micah ;
Rupp, Betty ;
Kwiatkowski, Evan ;
Psioda, Matthew A. ;
Sheth, Anandi N. .
JMIR RESEARCH PROTOCOLS, 2019, 8 (06)
[49]   Evaluating the long-term impact of the Trauma Team Training course in Guyana: an explanatory mixed-methods approach [J].
Pemberton, Julia ;
Rambaran, Madan ;
Cameron, Brian H. .
AMERICAN JOURNAL OF SURGERY, 2013, 205 (02) :119-124
[50]   Impact of the COVID-19 pandemic on Canadian transplant journeys: a mixed methods study [J].
Fox, Danielle ;
Hall, Marc ;
Thibodeau, Carrie ;
Coldwell, Kristi ;
Lauder, Lydia ;
Dewell, Sarah ;
Davidson, Sandra .
BMJ OPEN, 2023, 13 (12)