title: The perspective of rural physicians providing abortion in Canada: qualitative findings of the BC Abortion Providers Survey (BCAPS).
abstract: BACKGROUND
  An increasing proportion of Canadian induced abortions are performed in large urban areas. For unknown reasons the number of rural abortion providers in Canadian provinces, such as British Columbia (BC), has declined substantially. This study explored the experiences of BC rural and urban physicians providing abortion services.
  
  
  METHODS
  The mixed methods BC Abortion Providers Survey employed self-administered questionnaires, distributed to all known current and some past BC abortion providers in 2011. The optional semi-structured interviews are the focus of this analysis. Interview questions probed the experiences, facilitators and challenges faced by abortion providers, and their future intentions. Interviews were transcribed and analyzed using cross-case and thematic analysis.
  
  
  RESULTS
  Twenty interviews were completed and transcribed, representing 13/27 (48.1%) rural abortion providers, and 7/19 (36.8%) of urban providers in BC. Emerging themes differed between urban and rural providers. Most urban providers worked within clinics and reported a supportive environment. Rural physicians, all providing surgical abortions within hospitals, reported challenging barriers to provision including operating room scheduling, anesthetist and nursing logistical issues, high demand for services, professional isolation, and scarcity of replacement abortion providers. Many rural providers identified a need to "fly under the radar" in their small community.
  
  
  CONCLUSIONS
  This first study of experiences among rural and urban abortion providers in Canada identifies addressable challenges faced by rural physicians. Rural providers expressed a need for increased support from hospital administration and policy. Further challenges identified include a desire for continuing professional education opportunities, and for available replacement providers.
authors.affiliation: Women's Health Research Institute, British Columbia Women's Hospital, Provincial Health Services Authority, Vancouver, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dressler
authors.forename: Nanamma
authors.initials: N
authors.lastname: Maughn
authors.forename: Judith A
authors.initials: JA
authors.lastname: Soon
authors.forename: Wendy V
authors.initials: WV
authors.lastname: Norman
mesh_terms: D000028:Abortion, Induced; D001955:British Columbia; D005193:Family Planning Services; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D009873:Operating Rooms; D010820:Physicians; D011247:Pregnancy; D019035:Rural Health Services; D012424:Rural Population; D012919:Social Behavior; D012934:Social Isolation; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014505:Urban Population