scholarly journals Pathways to seeking medication abortion care: A qualitative research in Uttar Pradesh, India

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216738 ◽  
Author(s):  
Aradhana Srivastava ◽  
Malvika Saxena ◽  
Joanna Percher ◽  
Nadia Diamond-Smith
Keyword(s):  
Qualitative Research ◽  
Uttar Pradesh ◽  
Medication Abortion ◽  
Abortion Care

Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

2021 ◽  
pp. 0044118X2110110
Author(s):  
Laura E. Jacobson ◽  
Ana Maria Ramirez ◽  
Chiara Bercu ◽  
Anna Katz ◽  
Caitlin Gerdts ◽  
...  
Keyword(s):  
Young People ◽  
Quality Care ◽  
First Trimester ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Abortion Care ◽  
The Mean ◽  
Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

scholarly journals Identifying National Availability of Abortion Care and Distance From Major US Cities: Systematic Online Search (Preprint)

2017 ◽  
Author(s):  
Alice F Cartwright ◽  
Mihiri Karunaratne ◽  
Jill Barr-Walker ◽  
Nicole E Johns ◽  
Ushma D Upadhyay
Keyword(s):  
United States ◽  
The United States ◽  
Online Information ◽  
Medical Procedure ◽  
Online Search ◽  
Facility Locations ◽  
Medication Abortion ◽  
Abortion Care ◽  
Online Searches ◽  
Us Cities

BACKGROUND Abortion is a common medical procedure, yet its availability has become more limited across the United States over the past decade. Women who do not know where to go for abortion care may use the internet to find abortion facility information, and there appears to be more online searches for abortion in states with more restrictive abortion laws. While previous studies have examined the distances women must travel to reach an abortion provider, to our knowledge no studies have used a systematic online search to document the geographic locations and services of abortion facilities. OBJECTIVE The objective of our study was to describe abortion facilities and services available in the United States from the perspective of a potential patient searching online and to identify US cities where people must travel the farthest to obtain abortion care. METHODS In early 2017, we conducted a systematic online search for abortion facilities in every state and the largest cities in each state. We recorded facility locations, types of abortion services available, and facility gestational limits. We then summarized the frequencies by region and state. If the online information was incomplete or unclear, we called the facility using a mystery shopper method, which simulates the perspective of patients calling for services. We also calculated distance to the closest abortion facility from all US cities with populations of 50,000 or more. RESULTS We identified 780 facilities through our online search, with the fewest in the Midwest and South. Over 30% (236/780, 30.3%) of all facilities advertised the provision of medication abortion services only; this proportion was close to 40% in the Northeast (89/233, 38.2%) and West (104/262, 39.7%). The lowest gestational limit at which services were provided was 12 weeks in Wyoming; the highest was 28 weeks in New Mexico. People in 27 US cities must travel over 100 miles (160 km) to reach an abortion facility; the state with the largest number of such cities is Texas (n=10). CONCLUSIONS Online searches can provide detailed information about the location of abortion facilities and the types of services they provide. However, these facilities are not evenly distributed geographically, and many large US cities do not have an abortion facility. Long distances can push women to seek abortion in later gestations when care is even more limited.

scholarly journals Incidence of treatment for postabortion complications in India, 2015

2020 ◽  
Vol 5 (7) ◽  
pp. e002372
Author(s):  
Susheela Singh ◽  
Rubina Hussain ◽  
Chander Shekhar ◽  
Rajib Acharya ◽  
Melissa Stillman ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
Large Scale ◽  
National Level ◽  
Uttar Pradesh ◽  
Primary Source ◽  
Reproductive Age ◽  
Legal Abortion ◽  
Indian States ◽  
Medication Abortion ◽  
Postabortion Care

Abortion has been legal under broad criteria in India since 1971. However, access to legal abortion services remains poor. In the past decade, medication abortion (MA) has become widely available in India and use of this method outside of health facilities accounts for over 70% of all abortions. Morbidity from unsafe abortion remains an important health issue. The informal providers who are the primary source of MA may have poor knowledge of the method and may offer inadequate or inaccurate advice on use of the method. Misuse of the method can result in women seeking treatment for true complications as well as during the normal processes of MA. An estimated 5% of all abortions are done using highly unsafe methods and performed by unskilled providers, also contributing to abortion morbidity. This paper provides new representative abortion-related morbidity measures at the national and subnational levels from a large-scale 2015 study of six Indian states—Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh. The outcomes include the number and treatment rates of women with complications resulting from induced abortion and the type of complications. The total number of women treated for abortion complications at the national level is 5.2 million, and the rate is 15.7 per 1000 women of reproductive age per year. In all six study states, a high proportion of all women receiving postabortion care were admitted with incomplete abortion from use of MA—ranging from 33% in Tamil Nadu to 65% in Assam. The paper fills an important gap by providing new evidence that can inform policy-makers and health planners at all levels and lead to improvements in the provision of postabortion care and legal abortion services—improvements that would greatly reduce abortion-related morbidity and its costs to Indian women, their families and the healthcare system.

Provider practice models for and costs of delivering medication abortion — evidence from 11 US abortion care settings

Contraception ◽  
2007 ◽  
Vol 75 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Aimee Afable-Munsuz ◽  
Heather Gould ◽  
Felicia Stewart ◽  
Kathryn A. Phillips ◽  
Stephanie L. Van Bebber ◽  
...  
Keyword(s):  
Medication Abortion ◽  
Abortion Care ◽  
Practice Models ◽  
Provider Practice

scholarly journals Differential treatment in the provision of medication abortion at pharmacies in Uttar Pradesh, India

2021 ◽  
pp. 100025
Author(s):  
Ms. Joanna PERCHER ◽  
Ms. Malvika SAXENA ◽  
Dr. Aradhana SRIVASTAVA ◽  
Nadia DIAMOND-SMITH
Keyword(s):  
Uttar Pradesh ◽  
Differential Treatment ◽  
Medication Abortion

scholarly journals An “Invaluable Skill”: Reflections on Abortion Training and Postresidency Practice

2018 ◽  
Vol 50 (9) ◽  
pp. 691-693
Author(s):  
Samantha Greenberg ◽  
Melissa Nothnagle
Keyword(s):  
Family Medicine ◽  
Unintended Pregnancy ◽  
Emotional Reaction ◽  
Barriers To Learning ◽  
Medication Abortion ◽  
Abortion Care ◽  
Opt Out ◽  
Template Analysis ◽  
Data Saturation ◽  
Training Resources

Background and Objectives: The goal of this study was to explore family medicine residents’ experiences with abortion training and identify positive and negative influences, and facilitators and barriers to providing abortion care. Methods: We conducted a qualitative study of recent graduates of an urban family medicine residency in the Northeast United States with an opt-out abortion curriculum. Individual recorded interviews were conducted with two classes of graduated residents until data saturation was reached. Data were coded and interpreted by both authors using the template analysis method. Results: Twenty residents completed interviews. Most trainees had limited or no abortion exposure prior to residency but were open to learning abortion care. By graduation, residents reported confidence in providing options counseling for unintended pregnancy. Overall, residents felt more comfortable providing medication abortion than aspiration abortion. Many reported feeling less emotional reaction to medication abortion and noted more technical and logistical barriers to learning aspiration abortion. Logistical barriers impede integration of medication abortion into practice for many, but were perceived to be less difficult to overcome than barriers to aspiration abortion integration. All participants agreed abortion care fits into the scope of primary care. Due to a variety of barriers, few of those who had not previously planned to become abortion providers after graduation incorporated it in their practice. Conclusions: Abortion training prepared residents to counsel women with unintended pregnancy, but numerous barriers inhibit integration of abortion care into practice. Given limited abortion training resources and fewer perceived barriers to medication abortion provision, family medicine residencies may consider focusing training on medication abortion.

scholarly journals Knowledge, provision of information and barriers to high quality medication abortion provision by pharmacists in Uttar Pradesh, India

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Joanna Percher ◽  
Malvika Saxena ◽  
Pravesh Dwivedi ◽  
Aradhana Srivastava
Keyword(s):  
Uttar Pradesh ◽  
High Quality ◽  
Medication Abortion

scholarly journals Development and validation of a person-centered abortion scale: the experiences of care in private facilities in Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
May Sudhinaraset ◽  
Amanda Landrian ◽  
Patience A. Afulani ◽  
Beth Phillips ◽  
Nadia Diamond-Smith ◽  
...  
Keyword(s):  
Criterion Validity ◽  
Validity And Reliability ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Expert Review ◽  
Abortion Care ◽  
Health Clinics ◽  
Exploratory Factor Analyses ◽  
Centered Care ◽  
Surgical Abortion

Abstract Background There is a need for a standardized way to measure person-centered care for abortion. This study developed and validated a measure of person-centered abortion care. Methods Items for person-centered abortion care were developed from literature reviews, expert review, and cognitive interviews, and administered with 371 women who received a safe abortion service from private health clinics in Nairobi, Kenya. Exploratory factor analyses were performed and stratified by surgical abortion procedures and medication abortion. Bivariate linear regressions assessed for criterion validity. Results We developed a 24-item unifying scale for person-centered abortion care including two sub-scales. The two sub-scales identified were: 1) Respectful and Supportive Care (14 items for medication abortion, 15 items for surgical abortion); and 2) Communication and Autonomy (9 items for both medication and surgical abortion). The person-centered abortion care scale had high content, construct, criterion validity, and reliability. Conclusions This validated scale will facilitate measurement and further research to better understand women’s experiences during abortion care and to improve the quality of women’s overall reproductive health experiences to improve health outcomes.

scholarly journals Adoption of no-test and telehealth medication abortion care among independent abortion providers in response to COVID-19

2020 ◽  
Vol 2 ◽  
pp. 100049
Author(s):  
Ushma D. Upadhyay ◽  
Rosalyn Schroeder ◽  
Sarah C.M. Roberts
Keyword(s):  
Medication Abortion ◽  
Abortion Care
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