Contraception 116 (2022) 69–97
abortions or in distribution of abortion services provided (medication vs. procedural).
Conclusions: An increase in the proportion of medication abortions compared withprocedural abortions may suggest increasing access to medication abortion as clinics adapted to limitations of the COVID-19 pandemic. Utilization of telehealth did
not appear to decrease the availability of operative procedures or volume of services, suggesting that telemedicine is a favorable care delivery option for clinics
hoping to limit face-to-face interaction as the pandemic continues.

Results: 7,016 people assigned female and 360 assigned male at birth completed
the survey. Most females (79%) and males (59%) did not agree/strongly agree thatit should be against the law to end a pregnancy on your own without medical assistance, including those living in states with laws that criminalize self-managed
abortion (64% of females and 62% of males). Similarly, most did not agree/strongly
agree that people who self-manage an abortion should be reported to the police(72% and 57%), reported to child protective services (67% and 54%) or go to jail (81%and 68%, respectively). In multivariable analyses, factors associated with supporting
self-managed abortion legality or criminalization included sex, age, educational attainment, political party, and religious aﬃliation, but not residence in a state thatcriminalized self-managed abortion.
Conclusions: There is a general lack of public support for making self-managed
abortion illegal and punishing the people involved, although support varied.

http://dx.doi.org/10.1016/j.contraception.2022.09.048

P024“DOULAS DO NEED TO BE THERE TO SUPPORT IF THEY CHOOSE TO HAVEAN ABORTION”: FAMILY PLANNING ATTITUDES AND STIGMA AMONGDOULAS IN GEORGIA
AE Lindsey
National Asian Paciﬁc American Women’s Forum (NAPAWF), Washington, DC, US
EA Mosley, A Sayyad, D Turner, S Narasimhan

http://dx.doi.org/10.1016/j.contraception.2022.09.046

P022
GROWING NATIONAL INTEREST AND SUPPORT FOR ADVANCE PROVISIONAND OVER-THE-COUNTER ACCESS TO MEDICATION ABORTION
MA Biggs
Advancing New Standards in Reproductive Health (ANSIRH), University of California,
San Francisco, Oakland, CA, US
D Grossman, S Kaller, R Schroeder, L Ralph

Objectives: This community-engaged study examines abortion and family planning
doula services, attitudes toward these services, abortion stigma faced by abortion
doulas, and doulas’ recommendations to improve access to care.
Methods: From October 2020 to February 2022, academic researchers and acommunity-based maternal-child health organization conducted a cross-sectional,
mixed-methods study with full-spectrum doulas in Georgia, where maternal mortality is high but abortion and contraceptive access are restricted. We interviewed
and surveyed 20 doulas about their scope of abortion and contraceptive care, theirpersonal attitudes toward family planning, and experiences with abortion stigma.
Results: Our sample was diverse by race/ethnicity (45% Black/African American,40% White, 5% Latinx, 10% other) and services provided (85% birth, 60% postpartum, 40% full-spectrum, 35% abortion, 45% family planning). Participants reported
positive attitudes toward abortion and contraception (Stigmatizing Attitudes andBeliefs=22.29 on an 18–40 scale; adapted Sexual and Reproductive Health Stigma
Scale=8.6 on a 6–13 scale). Among abortion doulas, abortion provider stigma wasmoderate to high (average Abortion Provider Stigma Survey (APSS) score=24 on a17–27 scale), and resilience was moderate (average resilience score=7 on a 4–11scale).
Conclusions: This study contributes two main ﬁndings: ﬁrst, family planning andabortion care training are needed and desired by doulas of all kinds. Second, abortion stigma is being experienced by abortion doulas. As contraceptive and abortion
care is further restricted, doulas may serve as a vital link to family planning services. Increasing doulas’ capacity to provide contraceptive counseling and abortion
care is feasible and imperative.

Objectives: In 2017, we estimated that more than one-third of women support advance provision (44%) and over-the counter (OTC, 37%) access to medication abortion. We assess any changes in national interest and support for these models ofabortion care.
Methods: From December 2021 to January 2022, we administered a national
probability-based online survey of English- and Spanish-speaking people assigned
female at birth regarding their interest and support for accessing medication abortion in advance from a doctor for future use and OTC without a prescription, using
Ipsos KnowledgePanel. We estimated weighted frequencies and conducted bivariate
analyses to identify participant characteristics associated with interest and support
for each model.
Results: 7,016 people assigned female at birth completed the survey. Nearly halfstated they were in favor of advance provision (49%) and OTC (49%) access to medication abortion. The most common advantages of each model included privacy (51%and 44%), convenience (48% and 50%) and earlier access to care (45% and 44%); themost common disadvantages included taking the pills incorrectly (57% and 53%),
unanswered questions (45% and 46%) and being forced to take the medications (43%and 41%). Experiencing barriers accessing reproductive healthcare, mistreatment byhealthcare providers and identifying as a sexual and gender minority were associated with greater support for these models of care.
Conclusions: There is growing national support for streamlined access to medication abortion, particularly among those who have experienced challenges accessing
healthcare. As legal restrictions proliferate, these models of care have the potential
to increase access to abortion.

http://dx.doi.org/10.1016/j.contraception.2022.09.049

P025
MAIL-ORDER PHARMACY DISPENSING OF MIFEPRISTONE FOR MEDICATIONABORTION AFTER IN-PERSON CLINICAL ASSESSMENT
D Grossman
Advancing New Standards in Reproductive Health (ANSIRH), University of California,
San Francisco, Oakland, CA, US
S Raifman, N Morris, MA Biggs, A Arena, L Bachrach, J Beaman, A Collins, M Gold,
C Hannum, S Ho, T Middleton, EB Schwarz, K Tocce, S Seibold-Simpson, M Sobota,
D Wohler

http://dx.doi.org/10.1016/j.contraception.2022.09.047

P023
ADAPTATIONS TO COVID: ANALYSIS OF NATIONAL ABORTION CLINICSURVEY DATA
E Kravitz
Hospital of the University of Pennsylvania, Philadelphia, PA, US
J Chen, J Wu, N Koelper, A McAllister, S Sonalkar

Objectives: To investigate the acceptability, feasibility, and effectiveness of dispensing medications for abortion using a mail-order pharmacy following an in-personassessment.
Methods: We conducted a prospective cohort study of patients seeking medication abortion services at 11 sites in seven states. Patients interested in and eligible for medication abortion provided consent. Clinicians electronically sent prescribed mifepristone and misoprostol to the mail-order pharmacy, which shipped
these medications to participants’ preferred addresses. Participants completed webbased surveys about their experience and outcomes three days and 14 days postenrollment and had routine clinical follow-up. Clinic staff extracted clinical datafrom medical records. We performed descriptive analyses to assess outcomes of interest.
Results: Between January 2020 and April 2022, 408 participants enrolled, of which
three enrolled for two abortions (total sample: 411 pregnancies among 408 participants). Among the 94% (388/411) who took the medications and for whom clinicaloutcome data were obtained, 85% (329/388) received the medications within threedays, 0.8% (3/388) took mifepristone beyond 70 days’ gestation, and 1.6% (6/388)
did not take misoprostol as indicated. Complete medication abortion occurred in
380 cases (97.9%, CI, 96.0–99.1); among the others, 1.8% (7/388) were treated withaspiration and one continued the pregnancy. Almost all, 98% (380/388) and 94%

Objectives: To analyze changes in national abortion clinic practices and telehealthutilization during the COVID-19 pandemic.
Methods: We conducted descriptive analyses of nationwide abortion service trends
utilizing a longitudinal survey distributed by the Society of Family Planning.
The dataset comprised three surveys: T1 (February–March 2020), T2 (May–July2020), and T3 (August–October 2020). Demographic characteristics including region (Northeast, Midwest, South, Midwest, and West) and type of clinic site(academic/hospital-aﬃliated, Planned Parenthood, and independent) were provided
in the survey data. Wilcoxon rank sum and Kruskal-Wallis tests were utilized forstatistical analysis.
Results: There was no difference in the volume of abortion services provided nationwide over T1–T3. However, there was a signiﬁcant increase in the proportionof medical abortions compared to procedural abortions from T1 to T3 (26.7% to40.0%, p<0.05). Planned Parenthood/independent sites performed a signiﬁcantly
greater proportion of medication abortions than academic/hospital-aﬃliated clinic
sites (p<0.05) across all three time periods. There was no difference in utilizationof telehealth across the time periods, even when controlling for type of site andregion. Sites offering telehealth services did not experience changes in volume of79