Introducing medical abortion in Turkey: Perspectives of physicians

Abstract

Objective: To better understand the knowledge, attitudes, and perspectives on medical abortion (MA) held by physicians in Turkey. Methods: The study was conducted in 4 provinces. Pretested, structured, self-administered questionnaires were answered by 187 obstetricians-gynecologists (ob-gyns) and 268 general physicians (GPs). Results: Although MA is not yet available at reproductive health facilities in Turkey, 96% of the ob-gyns and 82% of the GPs said they had heard about it. Moreover, 60% of the former and 5% of the latter said they had performed MAs, most commonly using misoprostol alone. More than 90% of the ob-gyns and 13% of the GPs had performed surgical abortions, and most (71% and 78%) thought that MA should be offered in the country. Conclusion: Most physicians in Turkey are aware of MA, with a large majority supporting its wider use. However, their concerns about the method and the incorrect understanding of its risks and possible complications may explain the reluctance of some physicians to provide MA services. These issues should be covered in physician training programs before the formal introduction of MA, while advocacy efforts press for registering mifepristone and misoprostol for its use.

Primary care providers’ knowledge, attitudes and practices of medical abortion: a systematic review

“…In eight of the studies9 14–20 researchers investigated KAP of medical abortion among doctors and medical interns. Five studies21–25 were conducted on samples of nurses and nursing students, three research groups8 26 27 investigated KAP in pharmacists and six studies28–33 included data from mixed groups of health professionals.…”

“…In 12 of the studies14 15 18–25 32 33 researchers used surveys as their method of data collection. Interviews were used in five studies,17 27 28 30 31 and in the remaining five studies8 9 16 24 26 29 multiple methods of data collection were used such as focus group discussions, in-depth interviews, surveys and mystery client visits to pharmacies.…”

Expanding access to medical abortion: Perspectives of women and providers in developing countries

“…• Providers' and medical students' knowledge and opinions about MA (Brazil [15], China [16], India [17], and Turkey [18]). • Access to MA from the perspectives of women (Bolivia [19], India [20], Mexico [21], and Nepal [22]).…”

“…The studies' authors recommend that those who currently perform, assist, or refer women for abortion, or may do so in the future, receive more thorough, up-to-date information about MA and/or undergo better provider training [16][17][18]. Moreover, provider training should not be restricted to physicians and medical students.…”

Socialized Healthcare and Women’s Fertility Decisions

“…First of all, teenage pregnancy is universally accepted by public health officials as a public health and social problem associated with a myriad of negative consequences for both teenage mothers and their children and Turkey is no exception. 6 Moreover, adolescent pregnancy is 5 Obstetricians and gynecologists (ob-gyns), family physicians, and certified general practitioners (GPs) are legally permitted to provide clinical abortion services, and termination of pregnancy is mainly surgical (vacuum aspiration) (Akin et al, 2012). 6 The World Health Organization (2016) report that complications during pregnancy and childbirth are the leading cause of deaths globally for 15-19-year-old girls.…”