Attitudes of the Physician Membership of the Society for Adolescent Medicine Toward Medical Abortions for Adolescents

Abstract

ABSTRACT. Objective. To document the practices and attitudes of the US physician members of the Society for Adolescent Medicine (SAM) regarding adolescent abortion and contraception, as well as physician willingness to prescribe medical abortion if approved by the Food and Drug Administration (FDA).Design. Cross-sectional questionnaire survey. Participants. The entire physician membership of SAM (N ‫؍‬ 1001) was surveyed. A total of 713 physicians responded, with 668 usable surveys yielding an adjusted response rate of 70%.Results. Of the respondents, 81% were trained as pediatricians; 58% had additional adolescent medicine training. Ninety-six percent prescribed contraception for their patients. Sixty-one percent of respondents identified abortion as an option for pregnant adolescents in all circumstances, whereas 4% believed abortion should never be an option. Eighty-nine percent referred their patients for abortions; 90% were aware of medications to induce abortions medically. If these medications (methotrexate and misoprostol, RU-486) were FDA-approved, 42% would prescribe them for their patients; 34% were unsure. Fifty-four percent believed if medical abortions were routinely available, they should be available from primary care physicians.Physicians were significantly more likely to consider prescribing medical abortions if the physician were female, offered postcoital contraception, performed Norplant insertions, referred adolescents for abortions, or performed postabortion medical checkups. Physicians were no more likely to consider prescribing medical abortions according to physician age, specialty training, or date of residency training. Religious affiliation per se was not associated with likelihood of prescribing medical abortions, but Catholic physicians were significantly less likely to consider prescribing medical abortions.Conclusions. Virtually all SAM physician respondents (96%) reported that abortion for pregnant adolescents should be available under some circumstances. Forty-two percent would prescribe medical abortion if the medications were FDA-approved, suggesting that medical abortion would potentially be available to adolescents from a larger group of physicians than is currently available. Pediatrics 1998;101(5). URL: http://www. pediatrics.org/cgi/content/full/101/5/e4; adolescence, abortion, Society for Adolescent Medicine.

Knowledge of Medication Abortion Among Adolescent Medicine Providers

“…While there is no way to determine this, prior evaluations of SAHM and AAP members have reported that four to seven percent do not believe that abortion should be an option for adolescents. 4,13 We found similar trends in our data; almost ten percent of respondents did not believe in abortion and just over three percent of respondents believed that abortion is not okay under any circumstances. This suggests that response bias due to abortion beliefs may not be an issue in our survey, though any bias present could lead to an overestimation of provider knowledge, counseling, and service provision.…”

“…However, less than four percent of adolescent medicine clinicians surveyed currently provide medication abortion – a number that has not significantly changed in over a decade despite the fact that, in 1998, 42% of SAHM members said they would prescribe medication to induce an abortion if mifepristone received FDA approval. 13 Further evaluation of the educational opportunities, supports, and barriers to service provision and counseling would be helpful in better understanding this trend.…”

“…Questions were drawn from a previous study of adolescent medicine providers’ attitudes about medication abortion 13 and from a Kaiser Family Foundation study of women’s health care providers’ knowledge and behaviors regarding mifepristone. 14 We included additional questions to gather information on respondents’ provision of reproductive health services counseling, contraception, procedures performed, and referrals, as well as barriers and supports to medication abortion service provision.…”

Epidemiologia do abortamento na adolescência

“…Considerando as repercussões físicas de um abortamento induzido sem assistência médica e sabendo-se que o agravo do ponto de vista social e psicológico é ainda maior nesta faixa etária, muitos estudos insistem na necessidade de rever a legislação a respeito. Um estudo americano que aplicou um questionário para avaliar a atitude, com relação ao abortamento em adolescentes, de médicos pediatras ou com especialização em adolescentes, mostrou que 96% prescreveriam anticoncepção para elas e 61% identificariam o aborto como uma opção para gestantes adolescentes, em qualquer circunstância 11 .…”

Views on Abortion: A Comparison of Female Genetic Counselors and Women from the General Population

“…Although few studies have examined genetic counselors' attitudes toward abortion, there are a number of published studies that assess physicians' attitudes, specifically regarding their willingness to perform or refer a patient for an abortion (Aiyer et al 1999;Klamen et al 1996;Miller et al 1998). In the studies cited, more physicians were receptive to abortion for medically necessary reasons than for nonmedical reasons.…”