Beliefs and behaviors regarding abortion counseling among U.S. clinicians caring for adolescents

Study objective: To determine clinician factors associated with discussing abortion during pregnancy options counseling among adolescents.

Methods: We recruited and surveyed a convenience sample of U.S. clinicians who care for pregnant adolescent patients (N=146). Clinicians were recruited at a national conference, through listservs, and via a physician mailing list. We used chi-square tests to analyze differences in our primary outcomes (routinely discussing abortion, routinely providing abortion referrals, and not routinely advising patients seeking abortion against termination) by clinician demographics, beliefs, and practice settings.

Results: Fifty-seven percent of clinicians reported routinely discussing abortion with adolescent patients, 58% routinely referred for abortion, and 76% did not routinely advise against termination. Female gender, pediatric specialty, and practicing in an academic setting were associated with routinely referring for abortion and not routinely counseling against abortion (p<0.05). Additionally, state abortion laws at the time of the survey were associated with abortion discussion and referrals. Having "a personal objection to abortion" or "belief that abortion will harm patients" were negatively associated with each outcome (p <0.05).

Conclusion: Clinician demographics and personal beliefs were associated with differences among counseling. Although this was a small exploratory study, our findings highlight important clinician-level barriers to adolescents' access to abortion counseling and care.