EVALUATING ABORTION CARE QUALITY IN A CALIFORNIA STATE UNIVERSITY STUDENT HEALTH CENTER

Introduction: An unintended pregnancy is a pregnancy that was unwanted at the time of conception. In the United States (U.S.), there are 2.8 billion unintended pregnancies that occur annually and about half (40%) will result in an abortion. Medication abortion (MAB) is the most common type of in-person abortion that is 93-98% effective up to 77 days’ gestation. With the passage of Senate Bill [SB] 24, also known as The College Student Right to Access Act (2023), California (CA) is the first state to ever require college student health centers (SHCs) to provide MAB services on campus. Problem Statement: Since MAB is a brand-new service to college SHCs in CA, there is very limited information that exists to assess the degree by which it improves patient and practice outcomes related to abortion care. Purpose Statement: The purpose of this project was to conduct a program evaluation of the MAB services provided at a college SHC in Los Angeles County, CA. Theoretical Framework: The Plan-Do-Study-Act (PDSA) Model was used as a framework. Methods: The project conducted a retrospective analysis of MAB patients’ electronic health records at the SHC from January through December 2023. Outcome, process, and balancing measures were tracked. A patient satisfaction survey was also administered to assess the quality of MAB services and counseling received. Results: All of the MABs provided at the SHC were successful. There were no hospitalized adverse events or complications reported. Majority of the patients did not want to adopt a form of contraception after their MAB. There were no unnecessary clinic wait times. A good proportion of international students frequented the SHC for MAB services and accounted for unscheduled visits in between MAB appointments. Discussion: The project underscores the importance of evaluating a brand-new legislation and its profound impact on local college campuses in CA. SB 24 has significantly reduced the financial burden of pregnant college women who wanted an abortion. Contraceptive decision making, a comprehensive pain management regimen, and cultural considerations need to be addressed in the MAB patient education. Recommendations: Future recommendations include incorporating evidence-based strategies that support MAB patient education and contraceptive decision-making. Culturally-tailored interventions also need to be incorporated to reach the international student population that interact with the SHC for MAB services. Finally, a comprehensive pain management education is needed to adequately address the physical, emotional and psychological impact of going through an abortion process.