Spatial disparities and travel to freestanding abortion clinics in Canada

Sethna, Christabelle; Doull, Marion

doi:10.1016/j.wsif.2013.02.001

Cited by 60 publications

(54 citation statements)

References 21 publications

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“…Induced abortions are a common procedure for Canadians: nearly 1 in 3 women will experience an abortion during their reproductive lifetime . Despite this commonality, abortion access is uneven throughout Canada and British Columbia . Over the past few decades, the number of abortion providers in Canada has decreased, and fewer education programs are offering training in the area .…”

Section: Introductionmentioning

confidence: 99%

“…1 Despite this commonality, abortion access is uneven throughout Canada and British Columbia. [2][3][4][5][6][7][8][9][10] Over the past few decades, the number of abortion providers in Canada has decreased, and fewer education programs are offering training in the area. 6 This phenomenon, described as the greying effect, is a major contributing factor to the decline in access to abortion across Canada.…”

Section: Introductionmentioning

confidence: 99%

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Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia

Dowler

Rushton

Kornelsen

2019

J Midwife Womens Health

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Introduction Across Canada and internationally, access to abortion remains challenging, particularly for those living in rural and remote communities. International research and policy call for the training of advanced practice clinicians, including midwives, to provide abortion services to fill the ever‐increasing access gap. Research in other jurisdictions has examined the attitudes of midwives toward this potential expansion of scope of practice, but such studies have not been undertaken in British Columbia. This qualitative research study explored the attitudes of registered midwives toward expanding their scope of practice to include the provision of medication abortion in British Columbia. Methods In‐depth qualitative interviews with British Columbia registered midwives were conducted and analyzed using thematic analysis. Results Fifteen interviews were conducted. Analysis of the interviews identified 5 primary themes: the incorporation of medication abortion into the midwifery scope of practice to increase access, the congruence of the midwifery model of care and provision of medication abortion, the role of registered midwives as guardians of reproductive rights, the need for a paradigm shift in how the profession is viewed, and the practicalities of potential scope expansion. Discussion This study shows some British Columbia registered midwives are interested in including medication abortion in their scope of practice. Midwives have the potential to bridge some of the health care delivery gaps in areas underserved by abortion providers and communities where medication abortion is not available. Further research is needed to more fully understand the perspectives of registered midwives in British Columbia as a whole.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia

Dowler

Rushton

Kornelsen

2019

J Midwife Womens Health

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“…There are many factors that affect access to abortion in Canada, where only physicians are licensed to perform abortions. From a geographical perspective, access to abortion in Canada can be challenging, with potentially large distances between women and where abortion services are offered [3], [4].…”

Section: Introductionmentioning

confidence: 99%

“…In BC it is estimated that the proportion of abortions performed in rural or community hospitals decreased by at least 60% between 1995 and 2005 [6]. Increased distance to abortion providers is a major barrier to women accessing abortions [3], [7], [8].…”

Section: Introductionmentioning

confidence: 99%

The Perspective of Rural Physicians Providing Abortion in Canada: Qualitative Findings of the BC Abortion Providers Survey (BCAPS)

et al. 2013

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BackgroundAn increasing proportion of Canadian induced abortions are performed in large urban areas. For unknown reasons the number of rural abortion providers in Canadian provinces, such as British Columbia (BC), has declined substantially. This study explored the experiences of BC rural and urban physicians providing abortion services.MethodsThe mixed methods BC Abortion Providers Survey employed self-administered questionnaires, distributed to all known current and some past BC abortion providers in 2011. The optional semi-structured interviews are the focus of this analysis. Interview questions probed the experiences, facilitators and challenges faced by abortion providers, and their future intentions. Interviews were transcribed and analyzed using cross-case and thematic analysis.ResultsTwenty interviews were completed and transcribed, representing 13/27 (48.1%) rural abortion providers, and 7/19 (36.8%) of urban providers in BC. Emerging themes differed between urban and rural providers. Most urban providers worked within clinics and reported a supportive environment. Rural physicians, all providing surgical abortions within hospitals, reported challenging barriers to provision including operating room scheduling, anesthetist and nursing logistical issues, high demand for services, professional isolation, and scarcity of replacement abortion providers. Many rural providers identified a need to “fly under the radar” in their small community.DiscussionThis first study of experiences among rural and urban abortion providers in Canada identifies addressable challenges faced by rural physicians. Rural providers expressed a need for increased support from hospital administration and policy. Further challenges identified include a desire for continuing professional education opportunities, and for available replacement providers.

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“…7 Better access to mif epristone abortion provided by primary care providers, including family physicians, nurse practitioners and midwives, could reduce these gaps in service delivery and free up operating room time. Availability of mifepristone in other countries has been associated with abortions occurring earlier in gestation, when they are safer, and in reduced wait times for surgical abortions.…”

mentioning

confidence: 99%