Although this review can form a base for the national improvement of abortion access, the gap found in Australian research demonstrates a need for additional studies.
Objective
This study aimed to identify enablers and barriers to the provision of medication abortion in the primary health care setting of regional and rural areas of Victoria, Australia.
Design
An online cross‐sectional questionnaire was used.
Setting
Regional and rural areas of Victoria, Australia.
Participants
Thirty‐nine GPs and 30 primary health care nurses.
Main outcome measures
Abortion views, medication abortion knowledge and practice, interest in medication abortion training and provision, and perceived uptake barriers.
Results
Most participants reported being consulted by women with unintended pregnancies and most of them included abortion counselling in their consultation. However, familiarity with provision of medication abortion was limited, and only five GPs and two primary health care nurses were currently medication abortion providers. The majority of participants expressed a high level of interest in receiving medication abortion training, but indicated a wide range of barriers to service provision, such as a lack of training opportunities, legal uncertainties or surgical access concerns in case of complications.
Conclusions
Findings demonstrate the need for education on medication abortion and training opportunities. Most identified barriers to service uptake are addressable and relate to a lack of local support services, including the absence of a 24‐hour contact advice service, insufficient follow‐up access and a lack of local ultrasound facilities. These barriers require educational programs at professional, organisational and community level to ensure that interested rural and regional primary health care providers can start offering medication abortion for their patients.
Objective: To explore factors that can influence implementation of a nurse-led model of care for early medication abortion provision in the primary healthcare setting of regional and rural Victoria, Australia.Background: Global research indicates that an increased involvement of primary healthcare nurses in the delivery of early medication abortion provision has the potential to improve abortion access. In Victoria, access in regional and rural areas is restricted despite abortion being legal. A nurse-led early medication abortion provision model is feasible and can potentially improve the current situation.Study design and methods: An online threeround classic Delphi method was used. This paper reports the qualitative findings. Non-probability sampling techniques were used to recruit a panel of professional experts. Data from the three questionnaires were collected and analysed using thematic analysis. Factors influencing model implementation were categorised into the Capability, Opportunity, Motivation-Behaviour framework.Results: A total of 24 medical and other health professionals participated. They identified a range of factors that can hinder model implementation, including a lack of affordable medication abortion education, no remuneration for nurse-led early medication abortion provision, and concerns related to stigma and support.
Discussion and conclusion:Understanding and addressing barriers to model implementation may enable the development of primary healthcare nurses' role in the delivery of early medication abortion provision to improve abortion access. Impact: To improve abortion access in Victoria's under-served regions, the potential of nurse-led early medication abortion provision was explored. Barriers to model implementation relate to a lack of medication abortion education and funding, professional support and stigma concerns. The study identified a range of support elements that would enable primary healthcare nurses to develop new roles and responsibilities in the delivery of medication abortion services.
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