Perceptions of medication and procedural abortion among medication abortion patients in Mississippi, USA

Patients seeking abortion early in pregnancy have the option of pursuing medication or procedural abortion. The decision between the two should be based on fully informed consent regarding both types of abortion and factors that reflect patient preference and medical needs. However, stigma and misinformation, particularly about procedural abortion, may drive the decision instead. Drawing upon 50 interviews with respondents who had medication abortions in Alabama or Mississippi, USA, this paper explores retrospective evaluations of abortion method preferences. Both pull and push factors are identified. A sense that medication abortion was more 'natural,' and offered greater comfort, privacy and autonomy pulled respondents towards medication abortion. Explicit fears of (any) surgery, perceived risks of medical and psychological harms, and threats to future fertility pushed respondents away from procedural abortion to the point that some respondents opted for a contraindicated medication abortion over procedural abortion. Several others would have forgone abortion altogether if medication abortion had not been available. Further, in contrast to earlier studies, both Black and White women strongly preferred medication abortion. The paper concludes by considering what these trends might mean for reproductive autonomy and potential solutions.