Abortion services in Canada: results of the 2012 national survey

Norman, Wendy V.; Guilbert, Édith; Okpaleke, Christopher; Lichtenberg, Erik; Paul, Mandira; White, Katharine O.; Jones, Heidi E.

doi:10.1016/j.contraception.2014.05.030

Cited by 35 publications

(74 citation statements)

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“…In Canada, every province was represented, except for Prince Edward Island, for which no clinical site was identified. [18] Participating sites provided an estimated 419,159 first and second trimester abortions in the US and 75,650 in Canada in 2012. In the US, the majority (n = 363, 95.3%) of sites offering abortion services provided first trimester medication abortion compared to 25.6% (n = 20) in Canada.…”

Section: Resultsmentioning

confidence: 99%

First trimester medication abortion practice in the United States and Canada

et al. 2017

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We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were physicians in Canada, just under half (49.4%) were advanced practice clinicians in the US, which was more common in Eastern and Western states. All Canadian providers used misoprostol; 85.3% with methotrexate. 91.4% of US providers used 200 mg of mifepristone and 800 mcg of misoprostol, with 96.7% reporting home misoprostol administration. More than three-quarters of providers in both countries required an in-person follow-up visit, generally with ultrasound. 87.7% of US providers routinely prescribed antibiotics compared to 26.2% in Canada. Nonsteroidal anti-inflammatory drugs were the most commonly reported analgesic, with regional variation in opioid narcotic prescription. In conclusion, medication abortion practice follows evidence-based guidelines in the US and Canada. Efforts to update practice based on the latest evidence for reducing in-person visits and increasing provision by advanced practice clinicians could strengthen these services and reduce barriers to access. Research is needed on optimal antibiotic and analgesic use.

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Section: Resultsmentioning

confidence: 99%

First trimester medication abortion practice in the United States and Canada

et al. 2017

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“…Although access to abortion services can vary geographically, [20][21][22] there is no legal restriction based on a woman's age. 3 Parental consent is not required for adolescents aged 16 years or older or for counselled mature minors under 16 years of age.…”

Section: Resultsmentioning

confidence: 99%

Intergenerational abortion tendency between mothers and teenage daughters: a population-based cohort study

Liu

Farrugia

Vigod

et al. 2018

CMAJ

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“…In Canada, abortion is a publicly funded service. Abortion services are accessed in Canada either by selfreferral to an abortion/reproductive health care facility or through a referral from their family physician to an abortion provider [4,5]. In 2016, surgical terminations represented 94.7% of all first-trimester abortions across the country [2].…”

Section: Introductionmentioning

confidence: 99%

Implementation of mifepristone medical abortion in Canada: pilot and feasibility testing of a survey to assess facilitators and barriers

Devane

Renner

Munro

et al. 2019

Pilot Feasibility Stud

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Background: Direct primary care provision of first-trimester medical abortion could potentially address inequitable abortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso® (mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictions to distribution, prescribing, and dispensing would impede the uptake of this evidence-based innovation in primary care. We developed and pilot-tested a survey related to policy and practice facilitators and barriers to assess successful initiation and ongoing clinical provision of medical abortion service by physicians undertaking mifepristone training. Additionally, we explored expert, stakeholder, and physician perceptions of the impact of facilitators and barriers on abortion services throughout Canada. Methods: In phase 1, we developed a survey using 2 theoretical frameworks: Greenhalgh's conceptual model for the Diffusion of Innovations in health service organizations (which we operationalized) and Godin's framework to assess the impact of professional development on the uptake of new practices operationalized in Légaré's validated questionnaire. We finalized questions in phase 2 using the modified Delphi methodology. The survey was then tested by an expert panel of 25 nationally representative physician participants and 4 clinical content experts. Qualitative analysis of transcripts enriched and validated the content by identifying these potential barriers: physicians dispensing the medication, mandatory training to become a prescriber, burdens for patients, lack of remuneration for mifepristone provision, and services available in my community. To assess the usability and reliability of the online survey, in phase 3, we pilot-tested the survey for feasibility. Results: We developed and tested a 61-item Mifepristone Implementation Survey suitable to study the facilitators and barriers to implementation of mifepristone first-trimester medical abortion practice by physicians in Canada.

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Abortion services in Canada: results of the 2012 national survey

Cited by 35 publications

References 0 publications

First trimester medication abortion practice in the United States and Canada

First trimester medication abortion practice in the United States and Canada

Intergenerational abortion tendency between mothers and teenage daughters: a population-based cohort study

Implementation of mifepristone medical abortion in Canada: pilot and feasibility testing of a survey to assess facilitators and barriers

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