Knowledge of Medication Abortion Among Adolescent Medicine Providers

Abstract

Purpose Adolescents are at high risk for unintended pregnancy and abortion. The purpose of this study is to understand if providers caring for adolescents have the knowledge to counsel accurately on medication abortion, a suitable option for many teens seeking to terminate a pregnancy. Methods Using an online questionnaire, we surveyed US providers in the Society for Adolescent Health and Medicine on medication abortion. We conducted chi-squared analyses to evaluate medication abortion knowledge by adolescent medicine fellowship training, and to compare responses to specific knowledge questions by medication abortion counseling. Further, we examined the relationship between providers’ self-assessed and actual knowledge using ANOVA. Results We surveyed 797 providers, with a 54% response rate. Almost a quarter of respondents incorrectly believed medication abortion was not very safe, 40% misidentified that it was <95% effective, and 32% did not select the correct maximum recommended gestational age (7–9 weeks). Providers had difficulty identifying that serious complications of medication abortion are rare. Those who counseled on medication abortion had more accurate information in all knowledge categories, except for expected outcomes. Medication abortion knowledge did not differ by adolescent medicine fellowship completion. Less than a third of respondents had very good knowledge, and self-assessed knowledge minimally predicted actual knowledge (r2=0.08). Conclusions Knowledge regarding medication abortion safety, effectiveness, expected outcomes, and complications is suboptimal even among adolescent medicine fellowship trained physicians, and self-assessment poorly predicts actual knowledge. To ensure pregnant teens receive accurate counseling on all options, adolescent medicine providers need better education on medication abortion.

Factors Associated With Provision of Long-Acting Reversible Contraception Among Adolescent Health Care Providers

“…Limitations of this survey’s findings have been discussed previously,(8) and include lack of generalizability to all providers offering reproductive health services to adolescents. Specific limitations to these analyses include the small sample size of OB/FM-trained clinicians and our use of residency type to reflect exposure to procedural women’s health training.…”

“…There were 430 survey participants, resulting in a response rate of 54%. Respondent characteristics are reported in a prior publication,(8) and demographics can be seen in Table 1.…”

“…(8) For this study, we explored providers’ self-reported provision of LARC methods. We defined LARC providers as those who stated that they personally provided either contraceptive implants or IUDs as part of their routine clinical services.…”

Quantity over quality—Findings from a systematic review and environmental scan of patient decision aids on early abortion methods

“…Decision aids are particularly relevant for the early abortion context given the prevalence of biased information about abortion, relatively poor knowledge about the safety and consequences of abortion among the general public and the diminishing access to qualified abortion providers who often serve as an important source of trusted information . Moreover, because primary care providers sometimes have insufficient knowledge and training in early abortion methods, and counselling is not always well received from abortion providers, integrating a consistent, high‐quality decision aid may help health professionals across disciplines to better support women's decision making process. Even in areas where there may not be ready access to both methods, a decision aid may enable women to develop accurate expectations about the method that will be used and may also empower women as consumer advocates.…”

Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

“…However, although women in the USA tend to report satisfaction with abortion counselling generally, 19 current information provision about available methods may limit informed, values-consistent decision-making. Indeed, there is evidence that some adolescent medicine providers have poor knowledge about the safety and effectiveness of medical abortion, 20 and that some front-line health workers and social service providers feel they lack the necessary skills and information to adequately support women when considering early abortion. 21 Studies have also found that healthcare providers have not disclosed information about available second trimester abortion 22 or ectopic pregnancy treatment options, 23 potentially delaying women's care or exposing them to unnecessary risk.…”