Relationship between ultrasound viewing and proceeding to abortion.

OBJECTIVE Ultrasound scanning is a routine part of preprocedure abortion care, and many health care providers offer patients the opportunity to view their ultrasound images. It has been speculated that ultrasound viewing will dissuade women from having an abortion. We examine whether viewing the image is associated with choosing to continue the pregnancy. METHODS Data from medical records for 15,575 visits by women seeking abortion care at a large, urban abortion provider in 2011 were analyzed for factors associated with choosing to continue the pregnancy. All patients received a preprocedure ultrasound scan and were offered the opportunity to view the image. RESULTS Patients opted to view the ultrasound image 42.5% of the time. Nearly all pregnancies (98.8%) were terminated: 98.4% of pregnancies among women who viewed their ultrasound images and 99.0% of pregnancies among the patients who did not. Among women with high decision certainty, viewing was not associated with deciding to continue the pregnancy. Viewing was significantly associated with deciding to continue the pregnancy only among the 7.4% of women who reported medium or low decision certainty about having an abortion (adjusted odds ratio 3.21, 95% confidence interval 1.18-8.73). CONCLUSION Voluntarily viewing the ultrasound image may contribute to a small proportion of women with medium or low decision certainty deciding to continue the pregnancy; such viewing does not alter decisions of the large majority of women who are certain that abortion is the right decision. LEVEL OF EVIDENCE II.