Primary Care Clinicians' Interest In, and Barriers To, Medication Abortion

J Am Board Fam Med. 2024 Jul-Aug;37(4):680-689. doi: 10.3122/jabfm.2024.240005R1.

Abstract

Purpose: Providing medication abortion in the primary care setting is a promising way to increase access to abortion, a threatened service in many States. This study aimed to characterize primary care clinicians' interest in prescribing medication abortion, what barriers they face in adding this service, and what support they need.

Methods: Data were collected from 162 practicing primary care clinicians in Minnesota using an online survey with closed- and open-ended response options. Data were analyzed using descriptive statistics, group comparison analyses, and content analysis for the open-ended questions.

Results: Participants represented a diverse range of ages, years in practice, credentials, genders, and urban/rural practice settings, and held mixed knowledge and attitudes around medication abortion. All demographic groups surveyed expressed interest in prescribing medication abortion, with the strongest interest represented among younger respondents, women, and those practicing in urban settings. Clinicians who provide prenatal care or who already work with these medications in other contexts were more likely to want to add medication abortion to their practices. The most common barrier to providing medication abortion was a lack of knowledge about organizational policies and about the medications themselves. To empower clinicians to provide medication abortion, respondents voiced needing their health systems to build clear processes and wanting supportive networks of other clinicians for collaboration.

Conclusions: Given the interest of primary care clinicians in providing medication abortion, health systems have a valuable opportunity to increase access.

Keywords: Abortion-Induced; Access to Care; Contraceptive Agents; Family Medicine; Family Planning Services; Mifepristone; Minnesota; Misoprostol; Primary Health Care; Scope of Practice; Surveys and Questionnaires; Unplanned Pregnancy.

MeSH terms

  • Abortifacient Agents / administration & dosage
  • Abortion, Induced* / methods
  • Abortion, Induced* / statistics & numerical data
  • Adult
  • Attitude of Health Personnel*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Minnesota
  • Physicians, Primary Care / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data
  • Pregnancy
  • Primary Health Care* / statistics & numerical data
  • Surveys and Questionnaires / statistics & numerical data

Substances

  • Abortifacient Agents