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First trimester medication abortion practice in the United States and Canada
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 g...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638562/ https://www.ncbi.nlm.nih.gov/pubmed/29023594 http://dx.doi.org/10.1371/journal.pone.0186487 |
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author | Jones, Heidi E. O’Connell White, Katharine Norman, Wendy V. Guilbert, Edith Lichtenberg, E. Steve Paul, Maureen |
author_facet | Jones, Heidi E. O’Connell White, Katharine Norman, Wendy V. Guilbert, Edith Lichtenberg, E. Steve Paul, Maureen |
author_sort | Jones, Heidi E. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5638562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-56385622017-11-03 First trimester medication abortion practice in the United States and Canada Jones, Heidi E. O’Connell White, Katharine Norman, Wendy V. Guilbert, Edith Lichtenberg, E. Steve Paul, Maureen PLoS One Research Article 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. Public Library of Science 2017-10-12 /pmc/articles/PMC5638562/ /pubmed/29023594 http://dx.doi.org/10.1371/journal.pone.0186487 Text en © 2017 Jones et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Jones, Heidi E. O’Connell White, Katharine Norman, Wendy V. Guilbert, Edith Lichtenberg, E. Steve Paul, Maureen First trimester medication abortion practice in the United States and Canada |
title | First trimester medication abortion practice in the United States and Canada |
title_full | First trimester medication abortion practice in the United States and Canada |
title_fullStr | First trimester medication abortion practice in the United States and Canada |
title_full_unstemmed | First trimester medication abortion practice in the United States and Canada |
title_short | First trimester medication abortion practice in the United States and Canada |
title_sort | first trimester medication abortion practice in the united states and canada |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638562/ https://www.ncbi.nlm.nih.gov/pubmed/29023594 http://dx.doi.org/10.1371/journal.pone.0186487 |
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