Expanded Access to Postabortion Contraception under Oregon's Reproductive Health Equity Act

Objective: We describe the first 24 months of expanded family planning services for low-income immigrants under Oregon's Reproductive Health Equity Act. We examined postabortion contraceptive use in rural versus urban locations. Study Design: We conducted a historical cohort study of abortion services reimbursed under the Reproductive Health Equity Act in the first 2 years after its implementation (2018 and 2019). Our primary outcome was shift in contraceptive tier from a less effective method before an abortion to a more effective contraceptive method after an abortion. Our key independent variable was residence in a metropolitan or nonmetropolitan area. We tested the association of nonmetropolitan residence and shift to a tier 1 or tier 2 method after the abortion, controlling for other factors, using logistic regression. Results: Our analysis included 625 abortions from across the state. After an abortion, 68% of women transitioned to a more effective form of contraception. Nonmetropolitan residence was not significantly associated with a shift from no method or a tier 3 method to tier 1 or tier 2 method (adjusted odds ratio, 1.28; 95% confidence interval, 0.81–2.02) compared with metropolitan residence. Conclusions: The program was successful in helping women not wishing pregnancy to transition to a more effective contraceptive method postabortion, regardless of metropolitan location of residence.