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APHA Scientific Session and Event Listing

Challenges of Providing Second Trimester Abortion Care at a Clinic of Last Resort

Eleanor Drey, MD, EdM, Department of Obstetrics, Gynecology and Reproductive Health, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Ave., Ward 6D, San Francisco, CA 94110, 415-206-3659, dreye@obgyn.ucsf.edu

San Francisco General Hospital is one of the last remaining public hospitals in California. As part of its dedication to providing comprehensive care, SFGH offers high quality, sensitive and confidential abortion services through The Women's Options Center. Abortions are routinely performed to a maximum gestational age of 23 weeks. As access to abortion declines in California and across the country a growing number of women are seeking abortions at later gestational ages in the second trimester. Many of these women have concurrent medical conditions for which they have been refused care by other abortion providers. In addition these women have substantial psycho-social histories that require high levels of provider and institutional sensitivity. As a result of medical and psycho-social conditions, these complex cases require sophisticated medical care which is available only in a hospital-based setting. This paper reviews the current methods for providing abortion care and the risks associated with care at later gestational ages for women with complex medical and social conditions. In addition it discusses the need and difficulty training providers to provide this complex care. The growing strain on the public health system to be a provider of last resort is reviewed.

Learning Objectives:

Keywords: Abortion, Access to Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Public Health Aspects of Second Trimester Abortion Care

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA