J Turk1, U Landy2, F Preskill2, A Adler2, J Steinauer2. 1. The University of California, San Francisco Bixby Center for Global Reproductive Health. Electronic address: Jema.Turk@obgyn.ucsf.edu. 2. The University of California, San Francisco Bixby Center for Global Reproductive Health.
Abstract
OBJECTIVES: To explore the impacts of routine family planning and abortion training during residency on abortion practice between three and ten years after residency. METHODS: In 2018, we surveyed 771 graduated obstetrician-gynecologists at least three years after completing residency about their current abortion practice. All respondents consented to join a prospective cohort as part of routine, post-rotation evaluation of the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. We matched and then de-identified post-rotation and post-residency surveys, and conducted bivariate and multivariable analyses. RESULTS: Of 463 respondents (60% response rate), 188 (41%) reported that they provide abortions (median of eight abortions per month) in their current practice. Eighty-eight (19%) do not provide abortions but would if not restricted by their practice. One hundred-fifty respondents (32%) reported abortions are out of their practice scope or that someone else in their practice provides abortions, and 38 (8%) do not desire to provide abortion care. Two hundred twenty-six (54%) reported practice or hospital group restrictions to abortion care. In multivariable analyses controlling for demographics, training, attitude and practice factors; geographic location, practice restrictions and logistical barriers, among other variables, correlated with abortion practice (practice in the West: odds ratio (OR) 2.3; 95% confidence interval [CI], 1.3-4.2; p=0.01; logistical barriers: OR 0.3, CI 0.1-0.7, p=0.01; and practice restrictions OR 0.5, CI 0.3-0.8, p=0.01). CONCLUSIONS: Nearly half of Ryan Program-trained obstetrician-gynecologists provide abortions. However, many barriers prevent the integration of abortion into practice. Healthcare providers and leaders should work to eliminate barriers to the provision of abortion care. IMPLICATIONS: Regardless of their intentions at the time of training, nearly half of Ryan Program-trained obstetrician-gynecologists provide abortions in practice, and another 19% would if not restricted by their practice. Integrated training is critical to abortion care, and efforts to overcome practice barriers could improve access to comprehensive health care.
OBJECTIVES: To explore the impacts of routine family planning and abortion training during residency on abortion practice between three and ten years after residency. METHODS: In 2018, we surveyed 771 graduated obstetrician-gynecologists at least three years after completing residency about their current abortion practice. All respondents consented to join a prospective cohort as part of routine, post-rotation evaluation of the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. We matched and then de-identified post-rotation and post-residency surveys, and conducted bivariate and multivariable analyses. RESULTS: Of 463 respondents (60% response rate), 188 (41%) reported that they provide abortions (median of eight abortions per month) in their current practice. Eighty-eight (19%) do not provide abortions but would if not restricted by their practice. One hundred-fifty respondents (32%) reported abortions are out of their practice scope or that someone else in their practice provides abortions, and 38 (8%) do not desire to provide abortion care. Two hundred twenty-six (54%) reported practice or hospital group restrictions to abortion care. In multivariable analyses controlling for demographics, training, attitude and practice factors; geographic location, practice restrictions and logistical barriers, among other variables, correlated with abortion practice (practice in the West: odds ratio (OR) 2.3; 95% confidence interval [CI], 1.3-4.2; p=0.01; logistical barriers: OR 0.3, CI 0.1-0.7, p=0.01; and practice restrictions OR 0.5, CI 0.3-0.8, p=0.01). CONCLUSIONS: Nearly half of Ryan Program-trained obstetrician-gynecologists provide abortions. However, many barriers prevent the integration of abortion into practice. Healthcare providers and leaders should work to eliminate barriers to the provision of abortion care. IMPLICATIONS: Regardless of their intentions at the time of training, nearly half of Ryan Program-trained obstetrician-gynecologists provide abortions in practice, and another 19% would if not restricted by their practice. Integrated training is critical to abortion care, and efforts to overcome practice barriers could improve access to comprehensive health care.
Authors: Kornelia Zaręba; Valentina Lucia La Rosa; Stanisław Wójtowicz; Ewelina Kołb-Sielecka; Jolanta Banasiewicz; Michał Ciebiera; Grzegorz Jakiel Journal: Int J Environ Res Public Health Date: 2022-10-01 Impact factor: 4.614