‘Abortion’ or ‘termination of pregnancy’? Views from abortion care providers in Scotland, UK

BackgroundThe phrase ‘termination of pregnancy’ has recently been adopted by a number of British medical institutions as a preferred descriptor of induced abortion. How it is used by abortion care providers is unclear, although the ongoing stigmatisation of abortion may play a role.MethodsA mixed methods study of the views of abortion care providers in Scotland, UK. Self-administered anonymous questionnaires were distributed to abortion care providers at a national conference (Scottish Abortion Care Providers). The main outcomes measured were the proportion of respondents reporting that they found the terms ‘abortion’ and ‘termination of pregnancy’ to be distressing, and their preferred terminology for use in consultations with women. In-depth interviews were conducted with 19 providers from a single clinic in Scotland to contextualise use of the terminology.ResultsThe questionnaire was completed by 90/118 delegates (76%). More respondents indicated they found the term ‘abortion’ distressing (28%), compared with those who found ‘termination of pregnancy’ distressing (6%; P<0.0001). Interview participants reported that ‘termination of pregnancy’ was the default phrase used in consultations. Some respondents stated that they occasionally purposely used ‘abortion’ in consultations to emphasise the seriousness of the procedure (morally, physically and/or emotionally).Conclusions‘Termination of pregnancy’ is the most commonly used term to describe induced abortion in patient consultations in Scotland. This and the term ‘abortion’ appear to play different roles, with the former being used euphemistically, and the latter as a more emphatic term. Further research is warranted to investigate how this interacts with patient care, service provision, and abortion stigma.

Download Full-text

Pharmacist Segments Identified from 2009, 2014, and 2019 National Pharmacist Workforce Surveys: Implications for Pharmacy Organizations and Personnel

Pharmacy ◽

10.3390/pharmacy8020049 ◽

2020 ◽

Vol 8 (2) ◽

pp. 49 ◽

Cited By ~ 1

Author(s):

Jon Schommer ◽

William Doucette ◽

Matthew Witry ◽

Vibhuti Arya ◽

Brianne Bakken ◽

...

Keyword(s):

Patient Care ◽

Service Provision ◽

Care Service ◽

Professional Services ◽

Care Providers ◽

Hours Worked ◽

Care Services ◽

Patient Care Service ◽

System Improvement ◽

Pharmacist Workforce

Background/Objective: Findings from the 2009 and 2014 National Pharmacist Workforce Surveys showed that approximately 40% of U.S. pharmacists devoted their time primarily to medication providing, 40% contributed a significant portion of their time to patient care service provision, and the remaining 20% contributed most of their time to other health-system improvement activities. The objective of this study was to characterize the U.S. pharmacist workforce into segments based on the proportion of time they spend in medication providing and patient care services and compare changes in these segments between 2009, 2014, and 2019. Methods: Data from 2009, 2014, and 2019 National Pharmacist Workforce Surveys were analyzed. Responses from 1200 pharmacists in 2009, 1382 in 2014, and 4766 in 2019 were used for analysis. Respondents working in the pharmacy or pharmacy-related fields reported both their percent time devoted to medication providing and to patient care services. Medication providing included preparing, distributing, and administering medication products, including associated professional services. Patient care services were professional services designed for assessing and evaluating medication-related needs, monitoring and adjusting patient’s treatments, and other services designed for patient care. For each year of data, pharmacist segments were identified using a two-step cluster analysis. Descriptive statistics were used for describing the characteristics of the segments. Results: For each year, five segments of pharmacists were identified. The proportions of pharmacists in each segment for the three surveys (2009, 2014, 2019) were: (1) medication providers (41%, 40%, 34%), (2) medication providers who also provide patient care (25%, 22%, 25%), (3) other activity pharmacists (16%, 18%, 14%), (4) patient care providers who also provide medication (12%, 13%, 15%), and (5) patient care providers (6%, 7%, 12%). In 2019, other activity pharmacists worked over 45 hours per week, on average, with 12 of these hours worked remotely. Patient care providers worked 41 hours per week, on average, with six of these hours worked remotely. Medication providers worked less than 40 hours per week, on average, with just one of these hours worked remotely. Regarding the number of patients with whom a respondent interacted on a typical day, medication providers reported 18 per day, patient care providers reported 11 per day, and other activity pharmacists reported 6 per day. In 2009, 8% of patient care providers worked in a setting that was not licensed as a pharmacy. In 2019, this grew to 17%. Implications/Conclusions: The 2019 findings showed that 34% of U.S. pharmacists devoted their time primarily to medication providing (compared to 40% in 2009 and 2014), 52% contributed a significant portion of their time to patient care service provision (compared to 40% in 2009 and 2014), and the remaining 14% contributed most of their time to other health-system improvement activities. Distinguishing characteristics of the segments suggested that recent growth in the pharmacist workforce has been in the patient care services, with more being provided through remote means in organizations that are not licensed as pharmacies. The findings have implications for pharmacist training, continuing education, labor monitoring, regulations, work systems, and process designs. These changes will create new roles and tasks for pharmacy organizations and personnel that will be needed to support emerging patient care services provided by pharmacists.

Download Full-text

A művi abortusz a férfi partner szemszögéből

Orvosi Hetilap ◽

10.1556/650.2019.31350 ◽

2019 ◽

Vol 160 (18) ◽

pp. 694-699

Author(s):

Beáta Magda Nagy ◽

Adrien Rigó

Keyword(s):

Health Care Providers ◽

Induced Abortion ◽

Point Of View ◽

Female Partner ◽

Care Providers ◽

Male Partners ◽

Personal Support ◽

Abortion Care ◽

Post Abortion ◽

Emotional Balance

Abstract: Induced abortion is an intervention that scientific research primarily addresses from the concerned women’s point of view in terms of either the causes or the consequences of the abortion decision. Nevertheless, each case of abortion involves a man as much as a woman (in the same vein as conception), which calls for the better knowledge of male partners’ needs, expectations and experiences related to induced abortion. The present summary addresses male partners’ status and importance in abortion care in a practical approach based on professional considerations. Available empirical findings suggest that male partners’ involvement in abortion care has importance both in protecting men’s emotional balance and in providing support for women in adapting to the abortion process. Male partners’ deeper involvement possibly includes roles such as seeing the female partner to the intervention, participation in pre-abortion counselling, presence during the intervention, and participation in post-abortion care. Related findings show that all of these forms of support are related to women’s positive abortion-related experiences and thus to their better recovery (provided that the female partner expresses a need for her male partner’s personal support). Furthermore, male partners’ involvement in abortion care enables health care providers to tailor counselling (information on the intervention, on possible consequences, on contraceptive methods etc.) to men’s specific needs. These practices facilitate partners’ joint and informed decision making, joint responsibility for conception or contraception, and eventually contribute to reducing the incidence of induced abortion. Orv Hetil. 2019; 160(18): 694–699.

Download Full-text

Factors Associated with Unsafe Induced Abortion among Women who attended Fitche Hospital, Oromia, Ethiopia: Cross-sectional study

10.21203/rs.2.10385/v1 ◽

2019 ◽

Author(s):

Abebe Feyissa Amhare ◽

Dereje Gobena Alemayehu ◽

Alemtsehay Adam Bogale

Keyword(s):

Care Service ◽

Traditional Birth Attendant ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Induced Abortion ◽

Sectional Study ◽

Cross Sectional ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion

Abstract Background Unsafe induced abortion is one of the most medical and public health problems in developing countries including Ethiopia. Ethiopia has permitted abortion in specific legal circumstances when the conception of the fetus is caused by rape, incest, when continuation of pregnancy endangers the mother’s life. The aim of this study is to assess the magnitude and associated risk factors of unsafe induced abortion among women who received post abortion care service in Fitche Hospital. Methods Institutional based cross-sectional study was carried out among women who received post abortion care service at Fitche hospital from November 30, 2017 up to May 30, 2018. The data was collected using pre tested questionnaire and entered to EpiData version 3.1 software and analyzed using SPSS version 24. Descriptive statistics, multivariate logistic regression analysis and chi-square test were conducted. Results Three hundred and eight respondents (100% response rate) with mean age of 30 ± 9 years were participated in this study. From respondents, 45% had history of unsafe induced abortion and 27% of them reported the abortion was performed in house by traditional birth attendant. Single women were more likely practice unsafe induced abortion than widowed women [OR: 9.71; 95%CI (1.30 – 72.42)]. Women who had low monthly income [OR: 6.72; 95%CI (2.15 - 20.97)] and house wives [OR: 12.29; 95%CI (1.70 - 88.63)] were more likely practice unsafe induced abortion than counterparts. Failure of contraceptive methods, place of interference, method used for interference, a person who induced the abortion, a condition after procedure, and reasons to induce abortion were identified as association factors of unsafe induced abortion at P < 0.001. Conclusion The study assessed the magnitude and reported a significant association between unsafe induced abortion and socio-demographic factors, contraceptive practice, and abortion related items. These findings are positive enough to warrant a large-scale study to better understand the unsafe abortion vulnerability factors in Ethiopia.

Download Full-text

Self-managed Abortion as a Medico-legal Intervention in Ghana: a Systematic Review

10.21203/rs.3.rs-177196/v1 ◽

2021 ◽

Author(s):

Fred Yao Gbagbo ◽

Renee Aku Sitsofe Morhe ◽

Emmanuel Komla Senanu Morhe

Keyword(s):

Induced Abortion ◽

Google Scholar ◽

Care Providers ◽

Legal Intervention ◽

Abortion Care ◽

Maternal Morbidity And Mortality ◽

Comprehensive Abortion Care ◽

Unwanted Pregnancies ◽

Good Potential ◽

Implementation Gaps

Abstract BackgroundWe examined the potential of improving self-managed abortion as a medico-legal intervention of safely and effectively resolving unwanted pregnancies in Ghana.MethodsWe undertook a systematic literature review on self-managed or self-induced abortion within the context of Ghanaian laws. We searched for studies from Advanced PubMed Central and Google Scholar and repositories of Public Universities in Ghana. With search words of self-managed or self-induced abortion and Ghanaian law, we found 13,100 papers. The search was then narrowed to studies conducted between 2015-2020 of which 22 most related papers were selected with Six (6) from the Advanced Google Scholar search, 18 from PubMed and 1 unpublished postgraduate thesis from a public university library.ResultsDespite a liberal law that supported positive and quite well-decentralized service delivery policy, standards, and protocols development on abortion in Ghana, self-induced abortion remains criminalized. Nonetheless, the longstanding practice persists with no evidence of prosecution of the person(s) found violating the law within the period under review. The use of abortifacients procured from pharmacies and chemists that are not recognized abortion care providers has become the leading method of self-induced. Conclusion Despite criminalizing self-induced abortion, Ghana’s law on abortion is fairly liberal enough to permit the development of comprehensive abortion care policy, standards, and protocols that have a good potential of supporting improved self-managed abortion to reduce maternal morbidity and mortality in the country. Further studies are required for the exploration of ways of filling implementation gaps to harness the potentials of improving self-managed abortions in Ghana.

Download Full-text

Contraceptive situation and Influencing Factors in Guangdong Province: A comparative questionnaire study

10.21203/rs.3.rs-220653/v1 ◽

2021 ◽

Author(s):

FAN JIANG ◽

Yanxia Qu ◽

Peixuan Lin ◽

Li Li ◽

Qingshan Xuan ◽

...

Keyword(s):

Family Planning ◽

Health Care Providers ◽

Contraceptive Use ◽

Induced Abortion ◽

Care Providers ◽

Monthly Income ◽

Abortion Care ◽

Post Abortion Care ◽

Contraceptive Services ◽

Post Abortion

Abstract BackgroundThe aim of our study is to describe the status of induced abortion and contraceptive use in reproductive women and make clear the correlated factors in Guangdong province.MethodA self-administered questionnaire survey was conducted separately in 1839 individuals aged 18–49 and 900 health care providers from Guangdong province. The content of questionnaire was based on status of induced abortion and contraceptive use for the former and problems concerning contraceptive services for the latter. Systematic random sampling was used and data were analyzed using SPSS 19.0. Descriptive statistics and binary logistic regression were used in this study.Results30.61% of participants experienced the induced abortion. The rate of repeated abortion was 19.96% and it was 20.45% in persons under 20 years old. 18.23% of 1839 individuals chose LARC as the main contraceptive method. The females with college degree(Odds ratio, OR = 1.867; 95% confidence intervals 95%CI: 1.175–2.969), technologists(OR = 2.291; 95%CI: 1.063–4.936) and the persons whose monthly income were of between 3000–5000¥(OR = 1.920; 95%CI: 1.204–3.065) were more likely to use LARC. The younger females less than 30 years old and never using PAC services had lower odds of using LARC. The rate of post abortion care performance was merely 12.23%. Age, monthly income, occupation, living conditions and obtaining free contraceptives in time were all strongerly influence factors for the use of post-abortion care(P < 0.01). The satisfaction rate of free contraceptive services was about 57.44%. Variety uniformity, obtaining inconveniently and worrying about the quality were the main reasons. 66.22% of hospitals set up the department of family planning in our study. Highly work intensity(54.67%) and less leadership (40.22%) influenced health care providers to provide family planning services.ConclusionThe abortion rate was high especially in young women. There were many problems affecting contraceptive services which damaged women’reproductive health. Increasing government investment for family planning services, strengthening the construction of the family planning department and performing post abortion care and long-acting reversible contraception by taking relevant steps would be useful measures for improving current contraceptive status.

Download Full-text

Guidelines and best practice recommendations on contraception and safe abortion care service provision amid COVID-19 pandemic: Scoping review.

10.21203/rs.3.rs-25326/v1 ◽

2020 ◽

Author(s):

Lemi Belay Tolu ◽

Garumma Tolu Feyissa

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Service Provision ◽

Care Service ◽

Data Extraction ◽

Assessment Tools ◽

Safe Abortion ◽

Practice Recommendations ◽

Abortion Care ◽

Consensus Statements

Abstract Introduction: During pandemics there is uncertainty and information overload. Policy makers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available best guidelines, consensus statements, standard of practice and practice recommendations on contraception and safe abortion care service provision during the COVID-19 pandemics.Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health to locate guidelines, protocols, consensus statements and practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. We included English records labelled guideline, or recommendation, or consensus, or practice parameter, or position papers on contraception and safe abortion care service practice during the COVID-19 pandemics. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.Results: Eleven records on safe abortion care and nine records on contraception service were identified. Identified recommendations were categorized into thematic areas. The records addressed approaches to the safe medication and surgical abortion, self-serving family planning and long term and reversible contraception. We haven’t employed any of the quality assessment tools as the pandemic is new clinical entity and evidences are based on expert opinion and limited clinical evidence.Conclusions: Consensus statements and recommendations consistently stated that there should be access to contraception service and safe abortion care during the COVID-19 pandemics with the concerted effort of service re-organization. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine or digital health and community/home-based care or self-care.

Download Full-text

Pharmacist Contributions to the U.S. Health Care System

INNOVATIONS in pharmacy ◽

10.24926/iip.v1i1.190 ◽

2010 ◽

Vol 1 (1) ◽

Cited By ~ 6

Author(s):

Jon C. Schommer ◽

Lourdes G. Planas ◽

Kathleen A. Johnson ◽

William R. Doucette ◽

Caroline A. Gaither ◽

...

Keyword(s):

Health Care ◽

Cluster Analysis ◽

Patient Care ◽

Health Care System ◽

Service Provision ◽

Care Providers ◽

Patient Care Service ◽

Pharmacist Workforce ◽

The U.S ◽

Care System

Objective: The overall goal for this study was to conduct a segment analysis of the pharmacist workforce during 2009 based upon time spent in medication providing and in patient care services. Methods: Data for this study were obtained from the 2009 National Pharmacist Workforce Survey in which a random sample of 3,000 pharmacists was selected. Cluster analysis was used for identifying pharmacist segments and descriptive statistics were used for describing and comparing segments. Results: Of the 2,667 surveys that were presumed to be delivered to a pharmacist, 1,395 were returned yielding a 52.3% overall response rate. Of these, 1,200 responses were usable for cluster analysis. Findings from this study revealed five segments of pharmacists: (1) Medication Providers, (2) Medication Providers who also Provide Patient Care, (3) Other Activity Pharmacists, (4) Patient Care Providers Who also Provide Medication, and (5) Patient Care Providers. The results showed that, in 2009, 41% of U.S. pharmacists were devoted wholly to medication providing (Medication Providers). Forty-three percent of pharmacists contributed significantly to patient care service provision (Medication Providers who also Provide Patient Care, Patient Care Providers who also Provide Medication, and Patient Care Providers) and the remaining 16% (Other Activity Pharmacists) contributed most of their time to business / organization management, research, education, and other health-system improvement activities. Conclusions: Based on the findings, we propose that the pharmacy profession currently has, and will continue to build, capacity for contributing to the U.S. health care system in new roles for which they have been identified. However, as shifts in professional roles occur, a great deal of capacity is required related to new service provision. Resources are scarce, so an understanding of the most appropriate timing for making such changes can lead to cost-effective use of limited resources for improving patient care. Type: Original Research

Download Full-text

Assessing care trajectories of adolescent females seeking early induced abortion in New South Wales: multistage, mixed-methods study protocol

BMJ Open ◽

10.1136/bmjopen-2020-039819 ◽

2020 ◽

Vol 10 (10) ◽

pp. e039819

Author(s):

Anisa Rojanapenkul Assifi ◽

Melissa Kang ◽

Elizabeth Sullivan ◽

Angela J Dawson

Keyword(s):

Mixed Methods ◽

New South ◽

New South Wales ◽

Deep Understanding ◽

Induced Abortion ◽

Adolescent Females ◽

Mixed Methods Study ◽

Abortion Service ◽

Abortion Care ◽

South Wales

IntroductionIn Australia, New South Wales (NSW), abortion has recently been removed from the criminal code. Previous research from Australia and other high-income countries has focused on adult women’s access to abortion services. This protocol describes a five-stage mixed-methods study to determine the care trajectories and experiences of adolescent females, aged 16–19 years, seeking an early induced abortion in NSW. The aims are to (1) explore the needs and perspectives of adolescent females seeking sexual and reproductive health services in NSW and (2) develop a framework for abortion service provision for adolescents in NSW.Methods and analysisThis study comprises: (1) semistructured qualitative interviews with key informants, individuals with diverse, in-depth experience of providing and/or supporting abortion care in NSW; (2) a cross-sectional online survey of adolescent females residing in NSW; (3) case study interviews with adolescents females who have accessed an abortion service in NSW; (4) a co-design workshop with adolescents who took part in stage 3 to develop relevant knowledge and recommendations and (5) a knowledge dissemination forum with key stakeholders.Ethics and disseminationEthics approval has been received from the University of Technology Sydney Human Research Ethics Committee for this study. Data collection commenced in March 2019 and will continue until the end of 2020. This study aims to develop a deep understanding of adolescent abortion care trajectories and experiences of abortion services in NSW. The study will deliver co-produced recommendations to improve adolescent access to abortion information and services.

Download Full-text

A qualitative study of abortion care providers’ perspectives on telemedicine medical abortion provision in the context of COVID-19

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2021-201309 ◽

2021 ◽

pp. bmjsrh-2021-201309

Author(s):

John Joseph Reynolds-Wright ◽

Nicola Boydell ◽

Sharon Cameron ◽

Jeni Harden

Keyword(s):

Qualitative Research ◽

Great Britain ◽

Visual Cues ◽

Medical Abortion ◽

Care Providers ◽

Abortion Care ◽

Written Information ◽

Growing Body ◽

Depth Interviews

BackgroundTelemedicine for medical abortion care was rapidly introduced in Great Britain in response to the COVID-19 pandemic. A growing body of literature demonstrates that telemedicine abortion care is safe, effective and highly acceptable to patients. Less is known about the perspectives of abortion care providers (ACPs).MethodsQualitative research within the telemedicine abortion service in Lothian (Edinburgh and surrounding region), UK. We conducted qualitative in-depth interviews with ACPs between May and July 2020 (doctors, n=6; nurses, n=10) and analysed the data thematically.ResultsWe present three themes from our qualitative analysis: (1) Selective use of ultrasound – the move away from routine ultrasound for determination of gestational age was generally viewed positively. Initial anxiety about non-detection of ectopic pregnancy and later gestations was expressed by some ACPs, but concerns were addressed through clinical practice and support structures within the clinic. (2) Identifying safeguarding issues – in the absence of visual cues some ACPs reported concerns about their ability to identify safeguarding issues, specifically domestic violence. Conversely it was acknowledged that teleconsultations may improve detection of this in some situations. (3) Provision of information during the consultation – telephone consultations were considered more focused than in-person consultations and formed only part of the overall ‘package’ of information provided to patients, supplemented by online and written information.ConclusionsACPs providing telemedicine abortion care value this option for patients and believe it should remain beyond the COVID-19 pandemic. Safeguarding patients and the selective use of ultrasound can be initially challenging; however, with experience, staff confidence improves.

Download Full-text

A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

Conflict and Health ◽

10.1186/s13031-021-00338-9 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Maria Persson ◽

Elin C. Larsson ◽

Noor Pappu Islam ◽

Kristina Gemzell-Danielsson ◽

Marie Klingberg-Allvin

Keyword(s):

Health Care ◽

Health Care Providers ◽

Service Provision ◽

Care Providers ◽

Personal Beliefs ◽

Menstrual Regulation ◽

Humanitarian Settings ◽

Abortion Care ◽

Regulation Policy ◽

Comprehensive Abortion Care

Abstract Background Humanitarian settings are characterised by limited access to comprehensive abortion care. At the same time, humanitarian settings can increase the vulnerability of women and girls to unintended pregnancies and unsafe abortions. Humanitarian actors and health care providers can play important roles in ensuring the availability and accessibility of abortion-related care. This study explores health care providers’ perceptions and experiences of providing comprehensive abortion care in a humanitarian setting in Cox’s Bazar, Bangladesh and identifies barriers and facilitators in service provision. Method In-depth interviews (n = 24) were conducted with health care providers (n = 19) providing comprehensive abortion care to Rohingya refugee women and with key informants (n = 5), who were employed by an organisation involved in the humanitarian response. Data were analysed using an inductive content analysis approach. Results The national menstrual regulation policy provided a favourable legal environment and facilitated the provision of comprehensive abortion care, while the Mexico City policy created organisational barriers since it made organisations unable or unwilling to provide the full comprehensive abortion care package. Supplies were available, but a lack of space created a barrier to service provision. Although training from organisations had made the health care providers confident and competent and had facilitated the provision of services, their knowledge of the national abortion law and menstrual regulation policy was limited and created a barrier to comprehensive abortion services. Even though the health care providers were willing to provide comprehensive abortion care and had acquired skills and applied strategies to communicate with and provide care to Rohingya women, their personal beliefs and their perceptions of Rohingya women influenced their provision of care. Conclusion The availability and accessibility of comprehensive abortion care was limited by unfavourable abortion policies, a lack of privacy, a lack of knowledge of abortion laws and policies, health care providers’ personal beliefs and a lack of cultural safety. To ensure the accessibility and availability of quality services, a comprehensive approach to sexual and reproductive health and rights is needed. Organisations must ensure that health care providers have knowledge of abortion policies and the ability to provide quality care that is woman-centred and non-judgmental.

Download Full-text