Results of a 4-year study on 15,447 medical abortions provided by privately practicing general practitioners and gynecologists in France

Gaudu, Sophie; Crost, M.; Esterle, Laurence

doi:10.1016/j.contraception.2012.06.006

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…Nonetheless, the overall efficacy rate among different ethnic groups is close to 95%, and the reported complications requiring hospitalization are less than 0.5 % [3][4][5]. Failures are related to abortion after 49 days of gestation, lower doses of misoprostol, multiple pregnancies, and uterine anomalies [5][6][7]. The present patient had no related medical condition and received the standard approved regimen.…”

Section: Discussionmentioning

confidence: 86%

Abscess formation in ovarian endometriomas after failure of mifepristone-induced abortion

Chang¹,

Wang²,

Chao³

et al. 2016

Clin. Exp. Obstet. Gynecol.

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Objective: To report a case of abscess formation in bilateral ovarian endometriomas after failure of mifepristone-induced abortion. Case Report: A-36-year-old multiparous woman with bilateral ovarian endometriomas conceived spontaneously and received mifepristone to induce an abortion at 35 days' gestation. Fever and lower abdominal pain occurred 28 days after the abortion. The patient then underwent surgical curettage for an incomplete abortion complicated by endometritis. Her symptoms and signs became aggravated, and computed tomography showed a large ovarian abscess. She underwent laparoscopic drainage of the abscess plus the enucleation of the ovarian endometriomas, and received intravenous antibiotic treatment. She resumed menstruation one month later and was doing well at the 11-month follow-up. Conclusion: This case demonstrates the importance of combining antibiotic therapy with mifepristone to induce abortions in women with known ovarian endometriomas.

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Section: Discussionmentioning

confidence: 86%

Abscess formation in ovarian endometriomas after failure of mifepristone-induced abortion

Chang¹,

Wang²,

Chao³

et al. 2016

Clin. Exp. Obstet. Gynecol.

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“…Few abortions need to be provided by gynaecologists. General practitioners can safely and effectively play a major role in service delivery (Dressler et al, 2013;Gaudu et al, 2013;Dawson et al, 2017). Nurses, midwives and physician-assistants have all been found in clinical studies to be able to provide both early medical and early surgical abortion with similar outcomes to doctors (Gemzell-Danielsson and Kopp Kallner, 2014; Barnard et al, 2015).…”

Section: Expanding the Provider Poolmentioning

confidence: 99%

Decriminalising Abortion in the UK. What Would It Mean?

Bertini¹

2022

The New Bioethics

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Healthcare Improvement Scotland (Requirements as to Independent Health Care Services) 2011 (SSI No. 182) The Human Medicines Regulations 2012 (SI 1916) 68, Independent Health Care (Wales) Regulations 2011 (No. 734 (W.112)) Nursing and Midwifery Order 2001 (SI No. 253) 72, Registration of Social Care and Independent Health Care (Wales) Regulations 2002 (SI No. 919 (W.107)) IX Notes on contributors Marie Fox holds the Queen Victoria Chair of Law, in the School of Law and Social Justice at the University of Liverpool and is Associate Dean for Research and Impact. She has previously worked at the Universities of Lancaster, Queen's Belfast, Manchester, Keele and Birmingham. Her research is concerned with the legal governance of human and animal bodies, legal conceptions of embodiment and regulation of reproduction. Current projects (funded by the Dunhill Medical Trust, Wellcome Trust and Socio-legal Studies Association) focus on pet loss and the place of companion animals in care homes, governance of assisted reproductive technologies, and abortion law reform in Northern Ireland.

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“…Dutch guidelines about miscarriage management indicate the same (8). GPs already prescribe mifepristone and misoprostol for medical TOP in several other countries, including France and Ireland, showing positive results (9)(10)(11). In these countries, both GPs and patients report to be satisfied and that it is effective and safe (12).…”

Section: Introductionmentioning

confidence: 99%

Are Dutch General Practitioners willing to prescribe mifepristone and misoprostol?: a mixed-methods study

Schellekens

Houtvast

Leusink

et al. 2022

Preprint

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Background The World Health Organization (WHO) indicates that General Practitioners (GPs) can effectively and safely provide mifepristone and misoprostol for medical termination of pregnancy (TOP). Dutch GPs are permitted to treat miscarriages with mifepristone and misoprostol, but in practice only guide spontaneous miscarriages. Current Dutch abortion law forbids GPs to prescribe these medications for medical TOP. Medical TOP is limited to the specialized settings of abortion clinics and hospitals. A shift to primary care is debated in the House of Representative, following the example of France and Ireland. It would improve reproductive health care and choices for women. Little is known about GPs' willingness to provide medical TOP and miscarriage management. Aim This study aimed to gain insight into Dutch GPs' willingness and anticipated obstacles to prescribing mifepristone and misoprostol for medical TOP and miscarriages. Design and Setting This is a mixed-method study among Dutch GPs. Method A questionnaire provided quantitative data that was analysed using descriptive methods. Thematic analyses were performed on qualitative data collected by in-depth interviews. Results The questionnaire was sent to 575 GPs, the response rate was 22.1%. Of the responders, 84.3% were willing to prescribe mifepristone and misoprostol and 58.3% were willing to provide both medical TOP and miscarriage management. 57.5% indicated a need for training. The main barriers influencing GPs' willingness were lack of experience, knowledge, time and a restrictive abortion law. Conclusion Over 80% of the respondents were willing to prescribe mifepristone and misoprostol for medical TOP or miscarriages. Training, (online) education and a revision of the abortion law are recommended. Keywords Abortion, Induced; Abortion, Missed; General Practitioners; Mifepristone; Misoprostol; Netherlands How this fits in Medical TOP in the Netherlands can only be provided in abortion clinics and hospitals. GPs may prescribe these same medications for miscarriage management, but in practice only guide spontaneous miscarriages. To improve access to woman-centred care, it is important to allow GPs by law to provide medical TOP. Our study is the first to assess Dutch GPs' willingness to provide mifepristone and misoprostol and aims to understand enablers and barriers that give insight into the feasibility of a shift in care. Our results illustrate the need to revise laws and to provide training and education in the similar procedure of medical TOP and miscarriage management.

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Results of a 4-year study on 15,447 medical abortions provided by privately practicing general practitioners and gynecologists in France

Cited by 14 publications

References 20 publications

Abscess formation in ovarian endometriomas after failure of mifepristone-induced abortion

Abscess formation in ovarian endometriomas after failure of mifepristone-induced abortion

Decriminalising Abortion in the UK. What Would It Mean?

Are Dutch General Practitioners willing to prescribe mifepristone and misoprostol?: a mixed-methods study

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