Exploratory study of race- or ethnicity-based discrimination among patients receiving procedural abortion care

Objective: Explore relationships of race and ethnicity with experiences of race-or ethnicity-based dis-crimination during abortion care.Study Design: English-or Spanish-speaking individuals aged 18 to 50 completed cross-sectional, self-administered online surveys within 30 days of procedural abortion at 5 Northeastern U.S. reproductive health clinics from June 2020 toFebruary 2021. We considered any affirmative response on the Discrimi-nation in Medical Settings (DMS) scale evidence of race-or ethnicity-based discrimination. We performed bivariate analyses and logistic regression examining discrimination among Black non-Latinx, Latinx any race, Other race non-Latinx compared to White non-Latinx participants. We assessed associations be-tween discrimination and healthcare quality and satisfaction.Results: Participants (n = 163) averaged 27( +/- 6) years and self-identified as Black non-Latinx (36.2%), White non-Latinx (28.8%), Latinx of any race (27.0%), and Other non-Latinx (8.0%). Most were publicly insured (52.8%) and < 14 weeks gestation (90.8%).Overall, 15.3% reported race-or ethnicity-based discrim-ination during abortion care with Black non-Latinx more likely to report discrimination (23.7%; OR 7.00, 95% CI 1.50-32.59), while Latinx any race (15.9%, OR 4.26, 95% CI 0.83-21.74) and Other race non-Latinx participants (15.4%, OR 4.09, 95% CI 0.52-32.35) demonstrated statistically nonsignificant trend toward in-creased odds of discrimination compared to White non-Latinx (4.3%). Discrimination was associated with negative perceptions of: time with physician ( p = 0.03), patient care involvement ( p < 0.05), physician communication ( p = 0.01), care quality ( p = 0.02), and care satisfaction ( p < 0.01). Conclusion: Racially minoritized participants were more likely to report race-or ethnicity-based discrimi-nation during abortion care; Black non-Latinx reported highest odds of discrimination compared to White non-Latinx. Discrimination was associated with unfavorable healthcare quality measures.Implications: Race-or ethnicity-based discrimination during abortion care is disproportionately reported by racially minoritized populations, especially Black individuals, compared to White non-Latinx individu-als. Discrimination is significantly associated with negative experiences of care. Future work should verify findings in different regions and larger studies, and design and test discrimination-reduction interven-tions. (c) 2023 Elsevier Inc. All rights reserved.