Hospitals and their health systems are not advertising abortion in a way that is consistent with other common outpatient procedures, a cross-sectional observational study of U.S. hospital websites showed.
Of the 222 patient-facing websites sampled, 79.4% did not mention abortion, while only 11.1% did not mention colonoscopy, reported Ari Friedman, MD, PhD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, and co-authors.
Websites described offering abortion care 6.3% of the time compared with 85.6% for colonoscopy, they noted in the .
Furthermore, when abortion was mentioned, the information was found a mean of 0.5 pages lower in search engine results (1.6 pages for abortion vs 1.0 page for colonoscopy).
"We found that hospitals rarely advertise abortion provision on their websites, even among institutions with abortion training programs," the authors wrote, adding that ob/gyn residency websites also rarely disclosed opportunities for abortion training.
Looking specifically at the websites of hospital systems that participate in the national Ryan Residency Training Programs in Abortion and Family Planning, 47.7% offered abortion care compared with 4.5% of non-Ryan websites. However, even Ryan hospital websites were still more likely to offer colonoscopy than abortion (92.3% vs 47.7%).
There were also differences in patient instructions for pre- and post-procedural care. Only 42.2% of websites omitted this information about colonoscopy compared with 89.8% that omitted it for abortion. Websites were also less likely to provide contact information for scheduling an abortion versus a colonoscopy (34.4% vs 14.7%).
Ultimately, the authors concluded that their "results suggest that hospitals and their health systems are not advertising abortion in a manner consistent with other outpatient procedures nor consistent with medical society statements that abortion is routine, essential health care."
While most abortions occur at independent clinics, hospitals serve key roles in abortion care, they noted.
Friedman told 鶹ý that this study came about after hearing colleagues who provide abortions say that they felt that their health systems were not fully representing abortion care online.
"Researching information for healthcare is a frustrating experience in general," said Friedman. "You start with, 'what are my options in the area for abortion?' and we showed that only 6% of health systems are even providing [that] information."
Friedman noted that the findings speak to what healthcare systems view as essential healthcare and what services those same systems treat as non-essential, adding that not having abortion information easily available interferes with the doctor-patient relationship, and more importantly, adds potential barriers to patients seeking time-sensitive care.
For this study, the researchers analyzed the websites of nonfederal acute care hospitals listed in the 2019 American Hospital Association database that had at least one labor and delivery bed from August to September 2022, conducting Google searches for "abortion" and "colonoscopy."
The 24 states that have the most restrictive abortion policies were excluded.
Disclosures
Friedman is supported by the Public Interest Technology University Network, the Penn Medical Communications Research Institute, and the National Institute on Aging.
Co-authors reported relationships with Arnold Ventures, Brigham and Women's Hospital, Tufts School of Medicine, CVS Health, Lown Institute, VBID Health, MedPAC, UpToDate, Baystate Medical Center, and the New York County Medical Society.
Primary Source
Annals of Internal Medicine
Friedman AB, et al "Information about provision of abortion on U.S. hospital websites: a cross-sectional analysis" Ann Intern Med 2023; DOI: 10.7326/M23-1389.