Policy makers on the research team: real-time health policy improvements during mifepristone implementation research in Canada

Norman, Wendy V.; Munro, Sarah; Devane, Courtney; Guilbert, E.; Brooks, Melissa; Costescu, Dustin; Kaczorowski, Janusz; Renner, Regina; Soon, Judith A.; Ms, Wagner; Waddington, Ashley; Davies, Carmel; Kendall, Tamil; Dunn, Scott

doi:10.1016/j.contraception.2018.07.009

Cited by 2 publications

(4 citation statements)

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“…A lack of local infrastructure continues to impact NP provision of MA [ 39 , 41 ]. While there is optimism that the availability of MA has improved abortion access in rural/remote areas by allowing more providers to offer the service, providing in rural/remote areas has not been easy because of resource and collaboration restraints.…”

Section: Discussionmentioning

confidence: 99%

Barriers and enablers to nurse practitioner implementation of medication abortion in Canada: A qualitative study

Carson

Paynter²,

Munro³

et al. 2023

PLoS ONE

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In this study we explored nurse practitioner-provided medication abortion in Canada and identified barriers and enablers to uptake and implementation. Between 2020–2021, we conducted 43 semi-structured interviews with 20 healthcare stakeholders and 23 nurse practitioners who both provided and did not provide medication abortion. Data were analyzed using interpretive description. We identified five overarching themes: 1) Access and use of ultrasound for gestational dating; 2) Advertising and anonymity of services; 3) Abortion as specialized or primary care; 4) Location and proximity to services; and 5) Education, mentorship, and peer support. Under certain conditions, ultrasound is not required for medication abortion, supporting nurse practitioner provision in the absence of access to this technology. Nurse practitioners felt a conflict between wanting to advertise their abortion services while also protecting their anonymity and that of their patients. Some nurse practitioners perceived medication abortion to be a low-resource, easy-to-provide service, while some not providing medication abortion continued to refer patients to specialized clinics. Some participants in rural areas felt unable to provide this service because they were too far from emergency services in the event of complications. Most nurse practitioners did not have any training in abortion care during their education and desired the support of a mentor experienced in abortion provision. Addressing factors that influence nurse practitioner provision of medication abortion will help to broaden access. Nurse practitioners are well-suited to provide medication abortion care but face multiple ongoing barriers to provision. We recommend the integration of medication abortion training into nurse practitioner education. Further, widespread communication from nursing organizations could inform nurse practitioners that medication abortion is within their scope of practice and facilitate public outreach campaigns to inform the public that this service exists and can be provided by nurse practitioners.

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Section: Discussionmentioning

confidence: 99%

Barriers and enablers to nurse practitioner implementation of medication abortion in Canada: A qualitative study

Carson

Paynter²,

Munro³

et al. 2023

PLoS ONE

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“…[68,69] Mifepristone was approved in July 2015, although not commercially available until January 2017. Prior to provision of the first mifepristone, national collaborations between researchers, health professional organizations, regulators and policy makers [12,70] had resulted in the elimination of required observed dosing and had established in two of Canada's largest provinces (BC, Ontario) permission for any physician to write a prescription for mifepristone, which could be dispensed by any pharmacist. [71,72] Rapidly, other provinces followed.…”

Section: Trainingmentioning

confidence: 99%

“…[11,49,73,74] Emerging data on the uptake of this novel practice indicates more than twice as many practitioners engaged in medical abortion practice within the first year of availability, than had provided any abortion service prior to 2017, and in the two early adopter provinces within a year of the availability of subsidized mifepristone, nearly a third of all abortions were provided using mifepristone. [12,75] Canadian regulators, health professional organizations, researchers and policy makers worked together to translate global experience and research. They applied this evidence to the unique geographic challenges and context in Canada and implemented rapid uptake of practice, with minimal regulatory restrictions.…”

Section: Trainingmentioning

confidence: 99%

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When there are no abortion laws: A case study of Canada

Shaw

Norman

2020

Best Practice & Research Clinical Obstetrics & Gynaecol

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Canada decriminalized abortion, uniquely in the world, 30 years ago. We present the timeline of relevant Canadian legal, political and policy events prior to and since decriminalization. We explore implications for clinical care, health service and systems decisions, health policy and the epidemiology of abortion in the absence of criminal legislation. Since the criminal abortion law was struck down dozens of similar private member's bills, and one government bill, have been proposed, but none were passed. Key findings include that initially Canadian provinces attempted to provide restrictive regulations and legislation, all of which have been revoked and largely replaced with supportive policies that improve equitable, accessible, state-provided abortion service. Abortion rates have been stable over 30 years since decriminalization, and a falling proportion of abortions occur late in the second trimester. Canada demonstrates that abortion care can safely and effectively be regulated as a normal component of usual medical care.

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Policy makers on the research team: real-time health policy improvements during mifepristone implementation research in Canada

Cited by 2 publications

References 0 publications

Barriers and enablers to nurse practitioner implementation of medication abortion in Canada: A qualitative study

Barriers and enablers to nurse practitioner implementation of medication abortion in Canada: A qualitative study

When there are no abortion laws: A case study of Canada

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