title: Obstetrician-gynecologists' knowledge of and attitudes toward medical abortion in Guatemala.
abstract: OBJECTIVE
  To characterize the legal and clinical knowledge of Guatemalan obstetrician-gynecologists (OB/GYNs) regarding medical abortion and to determine factors associated with approval of its use for specific indications.
  
  
  METHODS
  A trained interviewer administered a multiple-choice survey to 172 private-practice OB/GYNs across Guatemala. Univariate, bivariate, and multivariate analyses characterized medical abortion opinion and knowledge, and logistic regression identified influential factors.
  
  
  RESULTS
  73% of OB/GYNs knew that abortion is legally permitted when the woman's life is at risk. Although 92% knew that misoprostol can be used to induce abortion, only 35% knew the WHO-recommended dosage. Only 25% knew of mifepristone. Compared with older OB/GYNs, those under 40 years of age were 7 times more likely, and 40-49 year olds were twice as likely to approve of medical abortion for fetal death and severe eclampsia with fetal death, respectively.
  
  
  CONCLUSIONS
  Current indications for abortion under Guatemalan law, as well as OB/GYN practices and beliefs regarding medical abortion, are hindering women's access to safe medical abortion and, therefore, potential reductions in maternal morbidity and mortality. Future research should aim to identify whether and why Guatemalan OB/GYNs are unfamiliar with these drugs, prefer to use other methods, or are completely against abortion.
authors.affiliation: Epidemiological Research Center in Sexual and Reproductive Health, Hospital General San Juan de Dios, Guatemala City, Guatemala. ekestler@ciesar.org.gt
authors.forename: Edgar
authors.initials: E
authors.lastname: Kestler
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000028:Abortion, Induced / Q000331:legislation & jurisprudence / Q000379:methods / Q000523:psychology*; D000328:Adult; D001291:Attitude of Health Personnel; D003625:Data Collection; D004305:Dose-Response Relationship, Drug; D005260:Female; D006166:Guatemala; D006176:Gynecology / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage / Q000627:therapeutic use; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use; D015999:Multivariate Analysis; D009774:Obstetrics / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D011247:Pregnancy
chemical_list: D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone