Patient Attitudes Toward Early Abortion Services in the Family Medicine Clinic

Abstract

Purpose: To examine urban, inner-city female patients' acceptability of the provision of early abortion services by their family physician in the family medicine clinic (FMC).Methods: We administered a survey with open-and closed-ended questions to a convenience sample of English-or Spanish-speaking female patients aged 18 to 45 recruited from a FMC in the Bronx, New York. Responses were analyzed using quantitative and qualitative methods.Results: One hundred forty-eight women completed the survey. The majority of respondents stated the FMC should offer abortion services. Seventy percent agreed their clinic should provide medication abortion, and 47% agreed their clinic should provide suction abortion. Of those who would personally consider an abortion, 73% responded that they would prefer to have it done by their family physician in the FMC, whereas 22% would prefer it at a freestanding, high-volume abortion clinic, and 5% had no preference.Conclusions: The majority of patients surveyed accepted the integration of abortion services into our FMC setting, and would choose to have an early abortion at their FMC. Increasing options for abortion provision within our FMC was acceptable to the majority of our sample. 2,3 most FPs do not routinely provide early abortion. Patients must therefore seek abortion services from unfamiliar providers, disrupting the "continuity of care" philosophy that is fundamental to the family medicine model. Althoguh several FPs and family medicine residency programs in the United States offer early abortions in their offices, 3-5 patient preferences for receiving early abortion services within primary care are not documented.Our main study objective was to determine whether women of reproductive age in an urban, inner-city family medicine clinic (FMC) would accept abortion being offered in the FMC, and if available, would choose have an abortion with their FP in their FMC. This research letter reports on the first phase of a project that will ultimately involve multiple FM and abortion clinics. MethodsAn anonymous survey with open-and closed-ended questions was administered at a FMC located in a predominately minority, low-income neighborThis article was externally peer reviewed. Submitted

Assessments of the Importance of Provider Characteristics for Abortion Care: Data From Women in Rajasthan, India

“…Indeed, our findings suggest that urban women, and particularly those of higher socioeconomic status, have stronger desires for autonomy and privacy in their reproductive decision-making than their rural and lower socioeconomic status counterparts. Indeed, preferences from these subgroups in our Indian sample echo those articulated among women in New York City and Romania (Johnson et al, 1996;Rubin et al, 2008). Surprisingly, we found very few differences in women's assessments of the importance of provider attributes based on their abortion history.…”

“…One study examined the acceptability of provision of abortions by family physicians among a convenience sample of women attending a family medicine clinic in New York City. Among the 90 women who said they would consider having an abortion, 73% said they would have their family physician perform it, while 22% said they would choose to have it in a large abortion clinic, and 5% had no preference (Rubin, Godfrey, & Gold, 2008). Only two studies have asked women specifically about the attributes of providers they value.…”

Evaluating the capacity of California's publicly funded universities to provide medication abortion

“…As a result, many are calling for the integration of early abortion into primary care settings [25,26], which for many students is an on-campus SHC. Studies have shown that women would prefer to receive abortion services at their primary care facility, because they feel connected to the setting, trust their provider, find it more convenient, and seek continuity of care [8,[27][28][29][30].…”

First Trimester Procedural Abortion in Family Medicine

“…9 In addition, one survey found that the majority of family medicine clinic patients who would consider using abortion services would prefer to receive them at their primary care clinic rather than visit a freestanding, high-volume abortion clinic. 10 The steps involved in procedural abortion are (1) counseling and evaluation before the procedure, including selection of pain control methods; (2) offering appropriate analgesia and/or anesthesia; (3) achieving adequate cervical dilation; and (4) complete aspiration of uterine contents. If the clinician is certain that the abortion is complete and if the patient chooses to initiate her contraceptive method at that visit, no follow-up appointment is needed.…”