152449 Barriers to Integrating early abortion into Primary Care

Tuesday, November 6, 2007

Ruth Lesnewski, MD , Reproductive Health Access Project, New York, NY
Lisa M. Maldonado, MPH , Reproductive Health Access Project, New York, NY
Linda Prine, MD , Reproductive Health Access Project, New York, NY
There are over 450 family medicine residency programs nationwide, yet fewer than 25 programs provide mandatory abortion training. The Reproductive Health Access Project estimates that about 50 family medicine residents graduate each with full training in medication and/or early suction abortion. Yet once they leave residency, few graduates are able to successfully integrate early abortion services into family medicine practices. Family physicians face multiple administrative barriers in providing early abortion services, including obtaining adequate malpractice, ensuring reimbursement, allaying staff concerns and purchasing needed equipment and medications.1 In addition, as the least senior physician in a new practice, they have little leverage to convince others to implement such a controversial service. Providing family physicians with support to work through these barriers could significantly expand access to early abortion services.

In order to better understand issues impeding trained family physicians from providing abortion care, the Reproductive Health Access Project conducted focus groups with family medicine educators, residents and newly trained family physicians. This qualitative research highlighted training issues and the need for on-going support. This session will present the findings from the focus groups and suggest strategies for addressing the issues uncovered.

Citations:

1. Seelig M, Gelbert L, Tavro P, Lee M, Rubenstein L. Determinants of Physician Unwillingness to Offer Medical Abortion using Mifepristone. Women's Health Issues 16 (2006) 14-21.

Learning Objectives:
1. Explain how training family physicians in medication abortion care could decrease the abortion provider shortage in the US. 2. List some of the barriers facing family physicians in providing abortion care 3. Discuss strategies to overcome the barriers to providing abortion care.

Keywords: Access and Services, Abortion

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.