Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.
BACKGROUND
Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically.


OBJECTIVE
Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians.


METHODS
Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic.


METHODS
A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion.


RESULTS
Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor.


CONCLUSIONS
A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.
Department of Internal Medicine, Beth Israel Medical Ctr., Albert Einstein College of Medicine, New York, NY 10003, USA. cpage@chpnet.org
Cameron
C
Page
Sarah
S
Stumbar
Marji
M
Gold
D000021:Abortifacient Agents, Steroidal / Q000600:supply & distribution*; D000028:Abortion, Induced / Q000379:methods / Q000523:psychology*; D000046:Academic Medical Centers / Q000458:organization & administration; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001294:Attitude to Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration*; D008875:Middle Aged; D015735:Mifepristone / Q000600:supply & distribution; D009519:New York City; D057240:Patient Preference; D011247:Pregnancy; D060728:Reproductive Health / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000458:organization & administration; D055815:Young Adult
D000021:Abortifacient Agents, Steroidal; D015735:Mifepristone