Abortion services in Canada: access and safety

Schummers, Laura; Norman, Wendy V.

doi:10.1503/cmaj.190477

Cited by 8 publications

(3 citation statements)

References 9 publications

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“…31 Our results suggest that providers might incorrectly perceive medical abortion risks to be greater than those related to continued pregnancy, despite strong evidence to the contrary. 1,[32][33][34] Loss to follow-up might occur for 10% to 20% of medical abortion cases. 35 International studies, however, have shown that severe complications are rare.…”

Section: Discussionmentioning

confidence: 99%

Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study

et al. 2020

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PURPOSE Access to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals and how these factors relate to abortion policies, systems, and service access throughout Canada. METHODS We conducted 1-on-1 semistructured interviews with a national sample of abortion-providing and nonproviding physicians and health system stakeholders in Canadian health care settings. Our data collection, thematic analysis, and interpretation were guided by Diffusion of Innovation theory. RESULTS We conducted interviews with 90 participants including rural practitioners and those with no previous abortion experience. In the course of our study, Health Canada removed mifepristone restrictions. Our results suggest that Health Canada's initial restrictions discouraged physicians from providing mifepristone and were inconsistent with provincial licensing standards, thereby limiting patient access. Once deregulated, remaining factors were primarily related to local and regional implementation processes. Participants held strong perceptions that mifepristone was the new standard of care for medical abortion in Canada and within the scope of primary care practice. CONCLUSION Health Canada's removal of mifepristone restrictions facilitated the implementation of abortion care in the primary care setting. Our results are unique because Canada is the first country to facilitate provision of medical abortion in primary care via evidence-based deregulation of mifepristone.

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Section: Discussionmentioning

confidence: 99%

Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study

et al. 2020

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“…32 Prisons are largely located outside of major urban centers, introducing transportation challenges. 33,34 Frequent staffing shortages in prisons 35 prevent prisons from arranging escorts for patients to receive off-site care. 36 A further barrier is information.…”

Section: Barriers To Carementioning

confidence: 99%

The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons

Paynter

Norman

2022

Semin Reprod Med

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Most incarcerated women are of reproductive age, and more than a third of women will have an abortion during their reproductive years. Although women are the fastest growing population in Canadian prisons, no one has studied the effect of their incarceration on access to abortion services. Studies outside of Canada indicate rates of abortion are higher among people experiencing incarceration than in the general population, and that abortion access is often problematic. Although international standards for abortion care among incarcerated populations exist, there conversely appear to be no Canadian guidelines or procedures to facilitate unintended pregnancy prevention or management. Barriers to abortion care inequitably restrict people with unintended pregnancy from attaining education and employment opportunities, cause entrenchment in violent relationships, and prevent people from choosing to parent when they are ready and able. Understanding and facilitating equitable access to abortion care for incarcerated people is critical to address structural, gender-, and race-based reproductive health inequities, and to promote reproductive justice. There is an urgent need for research in this area to direct best practices in clinical care and support policies capable to ensure equal access to abortion care for incarcerated people.

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“…Viewed through a health equity lens, disparities in abortion access and family planning services are exacerbated by social and economic factors, including abortion stigma; class, individual and systemic racism; ability; gender identity and sexual orientation; and geographical location. Geographical disparities are well researched in Canada (Kaposy 2010;Norman et al 2016;Sethna and Doull 2013); having timely access to a nearby provider improves clinical outcomes (Schummers and Norman 2019). People experiencing violence, poverty, racism, xenophobia, homophobia and/or transphobia face additional barriers to abortion care, including discrimination and trauma triggers in healthcare settings.…”

Section: Disparities In Abortion Carementioning

confidence: 99%

Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity

Carson¹,

Paynter²,

Norman³

et al. 2022

cjnl

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Registered nurses (RNs) provide abortion care in hospitals and clinics and support abortion care through sexual health education and family planning care in sexual health clinics, schools and family practice. Nurse practitioners (NPs) improve access to abortion not only as prescribers of medication abortion but also as primary care providers of counselling, resources about pregnancy options and NURSING RESEARCH 55Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity abortion follow-up care in their communities. There is a need to better understand the current status of and potential scope for optimizing nursing roles in abortion care across Canada. In this article, we describe the leadership of nurses in the provision of accessible, inclusive abortion services and discuss barriers to role optimization. We present key insights from a priority-setting meeting held in 2019 with NPs and RNs engaged in medication abortion practice in their communities. As scopes of practice continue to evolve, optimization of nursing roles in abortion care is an approach to enhancing equitable access to comprehensive abortion care and family planning.

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Abortion services in Canada: access and safety

Cited by 8 publications

References 9 publications

Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study

Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study

The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons

Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity

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