Article Figures & Data
Tables
Total Participants n = 56 (%) Gender Women 43 (76.8) Men 12 (21.4) Non-binary/third gender 1 (1.8) Race Asian 9 (16.1) Black or African American 5 (8.9) Native Hawaiian or Other Pacific Islander 1 (1.8) White 35 (62.5) Other 6 (10.7) Ethnicity Hispanic or Latino/a/x 3 (5.4) Non-Hispanic or Non-Latino/a/x 53 (94.6) Age (years) ≤30 1 (1.8) 31 to 40 45 (80.4) 41 to 50 5 (8.9) 51 to 60 4 (7.1) >60 1 (1.8) Regions of the U.S.† West 23 (41.1) South 13 (23.2) Midwest 6 (10.7) Northeast 14 (25) State Abortion Policy Landscape‡ Hostile 20 (35.7) Neutral 4 (7.1) Supportive 30 (53.6) N/A 2 (3.6) Approximate distance between physician’s clinical setting and nearest abortion clinic§ (miles) <5 32 (57.1) 5 to 25 15 (26.8) 26 to 50 4 (7.1) >50 4 (7.1) Unknown 1 (1.8) Abortion Training Aspiration and medication abortion 35 (62.5) Only aspiration abortion 3 (5.4) Only medication abortion 2 (3.6) Neither aspiration nor medication abortion 16 (28.6) Abortion services provided since graduating residency Aspiration and medication abortion 16 (28.6) Only aspiration abortion 0 Only medication abortion 5 (8.9) Neither aspiration nor medication abortion 35 (62.5) Current medication abortion provision Currently provides medication abortion 17 (30.4) Does not currently provide medication abortion 39 (69.6) Setting of current abortion provision Primary care 5 (8.9) Reproductive health clinic 10 (17.9) Primary care and reproductive health clinic 2 (3.6) N/A (Does not provide abortion care) 39 (69.6) ↵*Table adapted from Contraception, 2022.11
↵†U.S. Census Bureau, Census Regions and Divisions of the United States, 2013.
↵‡Nash E, State Abortion Policy Landscape: From Hostile to Supportive, Guttmacher Institute, 2019.
State categories were based on laws in effect as of July 1, 2020. N/A refers to areas where a state policy landscape was not available.
↵§ANSIRH, Abortion Facility Database, University of California, San Francisco, 2019. Distance was calculated using the zip code of the clinic where the provider works and the address of the closest clinic that offers abortion care in the ANSIRH Facility Database. If a provider works at multiple sites, the zip code of the furthest clinic from an abortion clinic was used.
Theme Quote Relationships I think that can be a scary situation for patients and especially culturally. For a lot of the patients that I serve, sometimes abortion is not necessarily something that, you know, their family or the people around them might approve of. And so being able to come to a clinic where they know that they can trust a person in there, that it's not – nobody else is gonna find out, that they can walk in and be able to ask questions, I think is really appropriate, or really important (P20, T, NP). Care across the lifespan There's no more common experience that a woman has than like either being pregnant, trying not to be pregnant… just like pregnancy is sort of all about that. I truly then also think prenatal care and preconception care are also a part of family medicine. And an important part of family medicine. So yeah, kind of across the board. Abortion belongs, belongs there (P15, T, NP).
We're the ones that see the patients the most, and so we should be the ones to be able to help them at all stages of their health care (P4, T, P).Whole-person care I would no more deny a patient the option of a medication abortion than I would deny a diabetic person insulin. You know, if that’s what they felt was right for them and it was clinically indicated…I would say abortion is health care…This is an aspect of health care. And we owe it to our patients to provide them excellent care that is consistent with available medical evidence (P28, T, NP).
Part of the reason why I chose family medicine is because I wanted to treat the whole patient so I think that, you know, saying, like, I will treat the whole patient except for this little area that I don’t feel comfortable treating and I’ll send that off to someone else, seems like kind of a cop out. So, I just – I think that is just another service that you can provide that just treats the whole person (P26, T, NP).Non-judgmental care My beliefs cannot interfere with what a patient may need. Or what a patient may require. So, I think again, there is the selflessness because whether or not I was for or against abortion, if a patient walked in and said, ‘Listen, this is what I need to do that’s best for me.’ Then I have to take myself out of the equation and educate again, give the information, provide the service if I have that capability, because it’s not about what’s best for me, it’s about what’s best for that patient (P27, NT, NP). Meeting community needs I think we often feel comfortable doing things that are, that fulfill a need for our patients. And this is like a really great example of something that aligns with our value of providing access for patients(P19, T, P). Reconciling values It’s always a very awkward experience for me when one of my patients has an unintended pregnancy and I have to refer them to someone else…I mean literally, I had a patient who came in for an IUD and I did a pregnancy test, she was pregnant, it was not planned. You know, obviously she’s getting an IUD. And, and I think I just wish like in that moment I could’ve just handed her a medication. And instead, it’s like well now I can’t do your IUD. But I can’t hand you a medication, which is much easier to do, I have to actually refer you out. And you have to call someone else. And you have to schedule an appointment and make a visit. …And so, it’s awkward… I know that they would just rather see me, and know me, and talk to me, and have me write them a prescription. And so, I think it’s awkward. And I think it’s disrupt-it’s disruptive to our relationship (P29, T, NP).
I know that I have the skillset to do these [medication abortions] and it feels foolish that I can't, you know? And I, like I-I've had many patients who I've had to refer to XXX [clinic name]. And it just, it just feels silly… And especially at this program, right? Like we do almost every office procedure you can do. Like toenail removals. All kinds of biopsies, colpo, endometrial biopsies, like whatever it may be. And so, the fact that we refer this out is just A: totally inconsistent with the other work that we do. And then B: just doesn't seem, it just doesn't seem logical (P15, T, NP).
It's very upsetting for me. For example, the one patient who felt like she financially and emotionally could not handle a child. But she did not get an abortion because she couldn't afford the abortion… I would love to be able to offer something else to those patients. Something that, you know, could help them through an already difficult time and not make their situation worse (P35, NT, NP).Abbreviations: T= Trained in abortion; NT= Not trained in abortion; P= Abortion provider; NP= Non-abortion provider.
