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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5638562?pdf=render |
| _version_ | 1818924721324949504 |
|---|---|
| author | Heidi E Jones Katharine O'Connell White Wendy V Norman Edith Guilbert E Steve Lichtenberg Maureen Paul |
| author_facet | Heidi E Jones Katharine O'Connell White Wendy V Norman Edith Guilbert E Steve Lichtenberg Maureen Paul |
| author_sort | Heidi E Jones |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-20T02:29:50Z |
| format | Article |
| id | doaj.art-2401f384809640e69c8ccb20bf9efa3a |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T02:29:50Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2401f384809640e69c8ccb20bf9efa3a2022-12-21T19:56:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011210e018648710.1371/journal.pone.0186487First trimester medication abortion practice in the United States and Canada.Heidi E JonesKatharine O'Connell WhiteWendy V NormanEdith GuilbertE Steve LichtenbergMaureen PaulWe 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.http://europepmc.org/articles/PMC5638562?pdf=render |
| spellingShingle | Heidi E Jones Katharine O'Connell White Wendy V Norman Edith Guilbert E Steve Lichtenberg Maureen Paul First trimester medication abortion practice in the United States and Canada. PLoS ONE |
| 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 |
| url | http://europepmc.org/articles/PMC5638562?pdf=render |
| work_keys_str_mv | AT heidiejones firsttrimestermedicationabortionpracticeintheunitedstatesandcanada AT katharineoconnellwhite firsttrimestermedicationabortionpracticeintheunitedstatesandcanada AT wendyvnorman firsttrimestermedicationabortionpracticeintheunitedstatesandcanada AT edithguilbert firsttrimestermedicationabortionpracticeintheunitedstatesandcanada AT estevelichtenberg firsttrimestermedicationabortionpracticeintheunitedstatesandcanada AT maureenpaul firsttrimestermedicationabortionpracticeintheunitedstatesandcanada |