RT Journal Article
SR Electronic
T1 Family Physicians' Barriers and Facilitators in Incorporating Medication Abortion
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 579
OP 587
DO 10.3122/jabfm.2022.03.210266
VO 35
IS 3
A1 Razon, Na'amah
A1 Wulf, Sarah
A1 Perez, Citlali
A1 McNeil, Sarah
A1 Maldonado, Lisa
A1 Fields, Alison Byrne
A1 Holt, Kelsey
A1 Fox, Edith
A1 Silverstein, Ilana
A1 Dehlendorf, Christine
YR 2022
UL http://www.jabfm.org/content/35/3/579.abstract
AB Purpose: Medication abortion (MAB) provision by family physicians has the potential to expand abortion access. However, there are documented individual and structural barriers to provision. This study investigates how family physicians in the United States (US) navigate the barriers impeding abortion provision in primary care.Methods: We conducted a qualitative study on the experiences of US family physicians with MAB in primary care. We recruited participants at national conferences and via professional networks. This analysis focuses on the experiences of the subset of participants who expressed interest in providing MAB.Results: Forty-eight participants met inclusion criteria, with representation from all 4 regions of the US. Participants had diverse experiences related to abortion provision, training, and the environment in which they practice, with a third of participants working in states with hostile abortion policies. We categorized participants into 3 groups: (1) doctors who did not receive training and do not provide abortions (n = 11), (2) doctors who received training but do not provide abortions (n = 20), and (3) doctors who received training and currently provide abortions (n = 17). We found that training, administrative and community support, and internal motivation to overcome barriers help family physicians integrate MAB in primary care practices. Federal and state laws, absence of training, stigma around abortion provision, inaccurate or limited knowledge of institutional barriers, and administrative resistance all contributed to doctors excluding abortion provision from their scope of practice.Conclusion: Improving medication abortion provision by family physicians requires addressing the individual and system barriers family physicians encounter so they receive the education, training, and support to successfully integrate abortion care into clinical practice.