98 Developing a Protocol for Medication Abortion in the Emergency Department: A Cross-sectional Survey of Emergency Physicians Regarding Providing Abortion Care

Preiksaitis, C.; Henkel, Andrea; Saxena, Mallika

doi:10.1016/j.annemergmed.2022.08.121

Cited by 2 publications

(3 citation statements)

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“…An educational didactic for ED faculty and residents was developed, focusing on options for counselling, medical abortion specifics and procedural flowcharts (online supplemental appendix 1). Prior to the study, only 10.3% of ED physicians reported discussing pregnancy options with patients 17. Clinicians were encouraged to probe into patients’ attitudes toward their pregnancies.…”

Section: Methodsmentioning

confidence: 99%

Initiating medical abortion in an emergency department in the United States

Preiksaitis,

Saxena,

Henkel

2024

BMJ Sex Reprod Health

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ObjectivesThe primary objective of this study was to assess the feasibility of initiating medical abortions in a large, academic emergency department (ED) in the United States.MethodsA retrospective case series analysis was conducted to evaluate a protocol for initiating medical abortion in the ED implemented from January 2020 to October 2023 at an academic, tertiary care hospital in California, USA. Participants included ED patients diagnosed with pregnancies in the first trimester that were undesired and who opted for medical abortion. The medical abortion protocol was collaboratively designed by a multidisciplinary team and follow-up was conducted by our institution’s gynaecology department. Data were sourced from a data repository of electronic health records and subjected to descriptive statistical analysis.ResultsA total of 27 eligible patients initiated medical abortions in the ED during the study period. The cohort was diverse in terms of racial and ethnic backgrounds and almost evenly split between private and public insurance. No patients had significant complications identified in the medical record. Two patients required uterine aspiration by the gynaecology team; one patient in clinic and one during a return visit to the ED.ConclusionsData from this case series suggest that initiating medical abortion in the ED is feasible. The ED may be considered as an additional access point for abortion care services, especially in areas where other care options are not readily available. Educational, legal and regulatory frameworks that allow emergency physicians to take a greater role in providing this care should be considered.

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Section: Methodsmentioning

confidence: 99%

Initiating medical abortion in an emergency department in the United States

Preiksaitis,

Saxena,

Henkel

2024

BMJ Sex Reprod Health

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“…In a survey of a single academic institution, Preiksaitis et al [13 ▪ ] found that most emergency medicine physicians reported comfort in diagnosing and disclosing the new diagnosis of a pregnancy. More than half reported exploring if the pregnancy is desired with patients (always 39.2%, often 28.9%) but fewer reported discussing options with the patient (always 10.3%, often 18.6%) (Fig.…”

Section: Abortion Carementioning

confidence: 99%

“…Emergency medicine physician reported frequency of discussing pregnancy desiredness and performing option counseling. Data from [13 ▪ ].…”

Section: Abortion Carementioning

confidence: 99%

The evolving role of emergency medicine in family planning services

Preiksaitis,

Henkel

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review The emergency department serves as an essential access point for a variety of healthcare services. This review will examine the recent expansion of family planning and reproductive health services in the emergency department. Recent findings An increasing number of patients present to emergency departments for early pregnancy loss (EPL), abortion care, and contraceptive management. Availability of comprehensive EPL management varies dramatically, possibly due to lack of provider knowledge or training. Particularly in remote settings, educational interventions – such as providing information about medication management and training in uterine aspiration – may standardize this management. Restrictive abortion laws raise concerns for changing and increased patient presentations to the emergency department for complications related to unsafe or self-managed abortion. Emergency medicine providers should anticipate that more patients will present without a prior ultrasound confirming intrauterine pregnancy prior to initiating no-touch or self-managed abortions. Particularly among pediatric patients, there may be a role for contraceptive counseling during an emergency department visit. Novel strategies, including web-based interventions and emergency department-based curricula for contraceptive counseling, may help reach those who otherwise may not seek reproductive healthcare in a clinic setting. Summary The intersection of emergency medicine and reproductive healthcare is a promising frontier for providing immediate, patient-centered, family planning care. Continued research and provider education are necessary to refine these approaches, address disparities, and respond to the changing reproductive healthcare landscape.

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98 Developing a Protocol for Medication Abortion in the Emergency Department: A Cross-sectional Survey of Emergency Physicians Regarding Providing Abortion Care

Cited by 2 publications

References 0 publications

Initiating medical abortion in an emergency department in the United States

Initiating medical abortion in an emergency department in the United States

The evolving role of emergency medicine in family planning services

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