Women’s and providers’ experiences of second-trimester abortion in the Heartland and the Northeast

Approximately one in ten abortions in the United States take place in the second trimester, but second-trimester care remains more stigmatized than abortion earlier in pregnancy and is often targeted by legislation that imposes limits on gestational age and otherwise restricts abortion access. There is little published research on women’s and providers’ (including clinicians and clinic staff) experiences with second-trimester abortion care.

This study aimed to address existing gaps in the literature and provide rich data about the experiences of second-trimester abortion providers and clients at clinics in the Midwest and Northeast. The mixed-methods study included: 1) 16 in-depth phone interviews with second-trimester abortion providers in the Midwest, 2) eight in-depth interviews with second-trimester clients in the Midwest, and 3) self-administered surveys with 108 second-trimester abortion clients in the Midwest and Northeast. Data collection took place from February 2013 to April 2014. To date, the in-depth interviews, collection of the self-administered surveys, and data analysis have been completed.

The analysis of the in-depth interviews with providers indicates that providers value their experiences of professional development and strive to offer patient-centered, non-judgmental care. Many providers also related experiences of stigma and social stress due to their roles in abortion care, and described the importance of receiving support from colleagues and other clinic staff as a coping mechanism. Preliminary analysis of the client interviews and surveys indicates that women face a number of barriers to accessing second trimester abortion care, including cost and travel arrangements, but receive high quality care and feel extremely supported by staff when they do access abortion care. The analysis of the survey data has also revealed that women seeking second-trimester abortions have mixed knowledge of and attitudes towards abortion restrictions, but that more women disagree with than agree with each of the abortion restrictions they were asked about.