Background: Since 2016, abortion care has undergone several important changes, particularly related to the provision of medical abortion using mifepristone. We aimed to document characteristics of the abortion care workforce in Canada after the update of clinical practice guidelines of mifepristone use for medical abortion.
Methods: We conducted a national, web-based, anonymized, bilingual (English/French) survey. We collected demographics and clinical care characteristics of physicians and nurse practitioners who provided abortion care in 2019. Between July and December 2020, we distributed the survey through professional organizations, including The College of Family Physicians of Canada and The Society of Obstetricians and Gynaecologists of Canada. We present descriptive statistics.
Results: Overall, 465 respondents representing all 10 provinces and 3 territories in Canada completed the survey. Of these, 388 (83.4%), including 30 nurse practitioners, provided first-trimester medical abortion, of which 350 (99.4%) used mifepristone. Two hundred and nineteen (47.1%) respondents provided first-trimester surgical abortion, 109 (23.4%) provided second-trimester surgical abortion and 115 (24.7%) provided second- or third-trimester medical abortion. Half of respondents reported fewer than 5 years of experience with any abortion care. Respondents reported providing a total of 48 509 abortions in 2019, including 32 345 (66.7%) first-trimester surgical abortions and 13 429 (27.7%) first-trimester medical abortions. In Quebec, only 1918 (12.5%) of reported abortions were first-trimester medical abortions. Primary care providers provided 34 540 (71.2%) of the total abortions. First-trimester medical abortions represented 44.4% ( = 2334) of all abortions in rural areas, as opposed to 25.6% ( = 11 067) in urban areas.
Interpretation: The increased availability of medical abortion facilitates abortion access, especially in primary care and rural settings, and where surgical abortion is not available. Rejuvenation of the workforce is a critical contributor to equitable access to abortion services.
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http://dx.doi.org/10.9778/cmajo.20210232 | DOI Listing |
Nursing
December 2024
Tammy McClung is a nursing instructor of the RN to BSN program at the College of Brockport, State University of New York, in Brockport, N.Y. She also holds a per diem clinical position in urgent care at the University of Rochester.
Magnetic resonance imaging (MRI) is a powerful diagnostic tool that uses strong magnetic fields and radio waves to create detailed images of the body's internal structures. This article examines the challenges associated with MRI, particularly focusing on patient anxiety and claustrophobic reactions that can lead to aborted scans. It discusses the use of anxiolytics, especially benzodiazepines, to manage these issues, while highlighting the potential risks of respiratory depression and other adverse outcomes in select patient populations.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
Malignant hyperthermia (MH) is a rare genetic disorder triggered by inhalational anesthetics or depolarizing neuromuscular blocking agents that carries significant mortality if not promptly treated. The following case presents a healthy 39-year-old man who developed MH several hours into an anesthetic exposure. Rapid intraoperative stabilization tactics that paralleled intensive care unit (ICU) level care allowed for continuation of operative management as opposed to case termination given the patient was at high risk for permanent nerve palsy if the case were to be aborted during dissection.
View Article and Find Full Text PDFJ Glob Health
January 2025
Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Background: Abortion-related complications significantly contribute to maternal morbidity and mortality globally. Post-abortion care (PAC) services are essential to safeguarding women's rights by substantially mitigating the health risks associated with abortions - a step which is fundamental to achieving reproductive and maternal health-related Sustainable Development Goals.
Methods: We conducted a secondary analysis of data from the nationally representative Service Provision Assessment (SPA) surveys conducted between 2015 and 2024 across three regions in seven low- and middle-income countries: Afghanistan, Bangladesh, Nepal, the Democratic Republic of Congo (DRC), Ethiopia, Senegal, and Haiti.
J Family Med Prim Care
December 2024
Dr. G.D. Pol 13Foundation, Y.M.T Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India.
The article presents the LGBTQIA + inclusivity analysis of the Medical Termination of Pregnancy (Amendment) Act 2021, which aims to provide safe abortion services across India. The analysis reports the use of cisgender-heteronormative language, instead of gender-neutral terms and pronouns in the legislation. Sexual assault/rape as an eligibility criterion for permitting abortion under this act does not apply to non-binary, trans- and queer individuals due to non-inclusivity in Rape Laws (Indian Penal Code 375 and 376).
View Article and Find Full Text PDFJ Law Med
November 2024
School of Nursing and Midwifery, Western Sydney University.
This article examines whether the current termination laws of Australia and Aotearoa New Zealand align with the midwifery scope of practice. It begins with an introduction to termination of pregnancy from a health care perspective. An overview of previous and current legal frameworks in Australia and Aotearoa New Zealand that impact upon the provision of termination of pregnancy health services is provided.
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