First-trimester medical abortion practices in Canada: National survey.
Can Fam Physician
; 62(4): e201-e208, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-28192275
ABSTRACT
OBJECTIVE:
To understand the current availability and practice of first-trimester medical abortion (MA) in Canada.DESIGN:
Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or electronic mail between July and November 2013.SETTING:
Canada.PARTICIPANTS:
A total of 94 abortion facilities were identified. MAIN OUTCOMEMEASURES:
Descriptive statistics on MA practice and facility and provider characteristics, as well as comparisons of MA practice by facility and provider characteristics using χ2 and t tests.RESULTS:
A total of 78 of 94 (83.0%) facilities responded. Medical abortion represented 3.8% of first-trimester abortions reported (2706 of 70 860) in 2012. Among the facilities offering MA, 45.0% performed fewer than 500 first-trimester abortions a year, while 35.0% performed more than 1000. More MAs were performed in private offices or ambulatory health centres than in hospitals. Sixty-two physicians from 28 of 78 facilities reported providing first-trimester MA; 87.1% also provided surgical abortion. More than three-quarters of MA physicians were female and 56.5% were family physicians. A preponderance (85.2%) of providers offered methotrexate with misoprostol. Nearly all physicians (90.3%) required patients to have an ultrasound before MA, and 72.6% assessed the completion of the abortion with ultrasonography. Most physicians (74.2%) offered MA through 49 days after the onset of the last menstrual period, and 21.0% offered MA through 50 to 56 days; 37.1% reported providing MA to patients who lived more than 2 hours away. Four physicians from 1 site provided MA via telemedicine.CONCLUSION:
In Canada, MA provision using methotrexate and misoprostol is consistent with best-practice guidelines, but MA is rare and its availability is unevenly distributed.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Primeiro Trimestre da Gravidez
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Aborto Induzido
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Instituições de Assistência Ambulatorial
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Instalações Privadas
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Can Fam Physician
Ano de publicação:
2016
Tipo de documento:
Article