Factors affecting delays in first trimester pregnancy termination services in New Zealand


Correspondence to:
Dr Martha Silva, Senior Research Fellow, School of Population Health, University of Auckland, Health Systems, Private Bag 92019, Auckland 1142, New Zealand; e-mail: m.silva@auckland.ac.nz


Objective: To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand.

Method: Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%).

Results: Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay.

Conclusions: Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve.