Health services provided at the time of abortion in the US: a scoping review of the qualitative and quantitative evidence

Author:

Mahoney Katherine M,Bravo Licia,McAllister Arden,Bogar Kacie,Hennessey Sean,Schreiber Courtney A.,Abernathy AliceORCID

Abstract

AbstractObjectivesWhile it is well documented that abortion access is associated with improved health, pregnancy-related, and socioeconomic outcomes, the association between abortion access and other reproductive health outcomes is less well described. Abortion-providing clinics also offer preventative reproductive health services. We conducted a scoping review to ascertain the extent to which preventive reproductive healthcare services (contraception, sexually transmitted infection testing and treatment, cervical cancer screening) are affected by abortion access in the United States.MethodsResearchers screened articles and extracted data from PubMed, Embase, Scopus and CINAHL. We excluded articles that did not link abortion to contraception, sexually transmitted infection testing and treatment and cervical cancer screening; or took place outside the US.Results5,359 papers were screened, 74 were included for full text review. Sixty-five were about contraception, seven on STIs, one on cervical cancer screening, and one on other services. The association between policies that restrict or protect abortion access and preventative health services has not been studied on a national scale. Drivers of variation were: insurance and billing policies; regulatory requirements of abortion-providing facilities, lack of staff training in clinics that did not specialize in abortion care; and limited follow up after abortion.ConclusionsAbortion--providing clinics are a highly utilized access point for reproductive health services. More research is needed to determine the public health impact of constrained abortion access on contraceptive use, STI rates and cervical cancer in regions where many abortion-providing clinics have closed.ImplicationsAttention should be paid to changing trends in contraceptive use, STI rates and cervical cancer as abortion-providing clinics close, this may reduce access to reproductive health services broadly.

Publisher

Cold Spring Harbor Laboratory

Reference12 articles.

1. Guttmacher Institute. For the First Time Ever, U.S. States Enacted More Than 100 Abortion Restrictions in a Single Year 2021 [cited 2023 Nov 28]. Available from: https://www.guttmacher.org/article/2021/10/first-time-ever-us-states-enacted-more-100-abortion-restrictions-single-year.

2. Guttmacher Institute. 100 Days Post-Roe: At Least 66 Clinics Across 15 US States Have Stopped Offering Abortion Care 2022 [cited 2023 Nov 28]. Available from: https://www.guttmacher.org/2022/10/100-days-post-roe-least-66-clinics-across-15-us-states-have-stopped-offering-abortion-care.

3. Guttmacher Institute. Interactive Map: US Abortion Policies and Access After Roe. [cited 2023 Nov 28]. Available from: https://states.guttmacher.org/policies/.

4. The Pregnancy-Related Mortality Impact of a Total Abortion Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant

5. Society of Family Planning clinical recommendations: contraception after surgical abortion;Contraception,2019

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