Less income, education affect pregnancy discovery
Low-income women with less education are significantly more likely to discover their pregnancies after six weeks, too late now for an abortion in Ohio, new research from Ohio State University suggests.
About 1 in 4 patients didn’t know they were pregnant before six weeks of gestation, the OSU study found. A fairly recent Ohio law being enforced now in the wake of the overturning of Roe v. Wade bans most all abortions after about six weeks. Prior to the so-called “heartbeat law,” the cutoff was 20 weeks, or 22 weeks as measured by a doctor.
A large percentage of pregnant women who want to terminate a pregnancy will now not be able to do so in Ohio, said the study’s lead author Abigail Turner, a professor in the department of internal medicine in the Ohio State College of Medicine.
“If they had been seeking abortion care in the current legal context, in Ohio, they would have no legal option for an in-state abortion because they didn’t learn about their pregnancy until after the sixweek limit,” Turner said.
Whether women discovered their pregnancy before or after six weeks, they took approximately the same amount of time before calling an abortion clinic prior to Ohio’s six-week ban, the study learned.
“Now, there will be the urgency,” Turner said.
The results are important in light of Ohio’s ban on abortions after six weeks, or 42 days of pregnancy, although data for the OSU study was gathered prior to this summer’s Supreme Court ruling overturning Roe v. Wade.
“Regardless of when pregnancy is discovered, six-week bans disrupt care for nearly all patients,” she said. “When you also consider the requirement of at least two clinic visits, a mandatory 24-hour waiting period, staff shortages and high demand, some people who know they are pregnant before six weeks are likely still not going to be able to get abortions before the sixweek limit.”
The OSU study was recently published in the American Journal of Obstetrics and Gynecology.
“Many people choose abortion because they don’t have enough money or want to pursue higher education before raising children. We learned in this study that those same factors are associated with not knowing you are pregnant until after six weeks — so people in this position are trapped,” Turner said.
Structural inequities in health care also come into play, Turner said. People with less income are less likely to have high-quality health insurance that enables them to access care quickly.
Low-income women might not seek care after skipping just one period, because they have so many other priorities that are more pressing, such as transportation, employment or child care issues, she said.
The researchers also wanted to understand whether people who knew they were pregnant before six weeks had a different “deliberation window” than those who learned of their pregnancy after six weeks.
Whether women discovered their pregnancy before or after six weeks, they took approximately the same amount of time before calling an abortion clinic — ahead of the law change. “Now, there will be the urgency,” Turner said.
The results highlight women’s need for an adequate time to make their decision without feeling pressured, she said.
“This has to be a decision that gets the whole deliberation that that individual person feels it needs,” Turner said.
In Ohio, only 27.5% of abortions in 2019 happened before the six-week mark, according to data from the Centers for Disease Control and Prevention’s Abortion Surveillance reports. The largest share of abortions in 2019 happened just after that point, from weeks seven to nine, at 45.1%.
The OSU study found that about 89% of its survey participants had their abortion later than the current Ohio law allows, even though the majority discovered their pregnancy before six weeks.
The CDC data came from state health department reports on abortion, Turner said.
In contrast, the OSU study was based on a confidential survey, conducted in 2020 and 2021, of 1,141 abortion patients who consented to participate in a research study after they had the procedure, Turner said.
Ohio abortion clinic patients were asked to complete the study’s online survey within 24 hours of their visit. Study participants could have been at their first or second visits to the clinic. Only women who had the procedure were included in the OSU study.
Study participants also were asked about the factors that led to their decision to end their pregnancies, but those responses are not part of this OSU study. That part of the survey may be the basis for future research, Turner said.