Estimating abortion provision and abortion referrals among United States obstetrician-gynecologists in private practice

Abstract

Objective: The objective was to examine the provision of abortion by obstetrician-gynecologists in private practice in the United States (U.S.) and their willingness to provide referrals for abortion services.

Study design: We conducted a cross-sectional national survey of 1961 U.S. obstetrician-gynecologists to estimate the frequency with which abortions and referrals for abortion care were provided in private practice settings. Key measures included whether respondents had provided any abortions in 2013 or 2014, type of abortions provided and willingness to provide abortion referrals. Facility location by region was the only measured correlate of abortion provision.

Results: We received a total of 988 surveys for a response rate of 65%. Sixty-seven (7%) obstetrician-gynecologists reported providing at least one abortion in 2013 or 2014, though this result ranged from 4% (n=23) to 13% (n=44) of obstetrician-gynecologists depending on survey response type. Among physicians practicing in the Northeast and West, 14% and 10%, respectively (n=24 in each region) were abortion providers compared to 4% (n=9) and 3% (n=10) of physicians in the Midwest and South, respectively. Twenty-three (42%) providers indicated only performing surgical abortions, 14 (25%) indicated only medication abortions, and 18 (33%) reported providing both. Among respondents who did not provide abortions, just over half (n=415, 54%) indicated that they referred patients to a facility or practice where they could obtain an abortion, but 271 (35%) said they would not provide a referral.

Conclusions: Only a small proportion of all obstetrician-gynecologists in private practice settings provide abortions. Among nonproviders, a substantial minority do not offer abortion referrals.

Implications: Particularly in geographic areas with few abortion providers, continued efforts are needed to equip medical professionals with information and training to make direct referrals.

Keywords: Abortion; OB/GYNs; Private practice; Referrals; Service provision.

Fig. 1

Percent distribution of obstetrician-gynecologists who neither perform abortions nor provide abortion referrals, by region and type of survey response. All respondents include initial respondents and follow-up respondents. Initial respondents are those who responded to the initial request and completed a paper survey.Follow-up respondents are those who provided information during telephone follow-up.

Fig. 2

Percent distribution of abortion referral practices among obstetrician-gynecologists who do not provide abortion, by type of survey response. All respondents include initial respondents and follow-up respondents. Initial respondents are those who responded to the initial request and completed a paper survey. Follow-up respondents are those who provided information during telephone follow-up.