Dr. Heidi Jones, a professor at the CUNY Graduate School of Public Health and Health Policy and colleagues recently published two studies on abortion practices in Canada.
The results are published in Canadian Family Physician.
The objective of the first study was to understand the current availability and practice of first-trimester abortion in Canada. The research team used public sources and professional networks to identify abortion facilities across Canada. The team sent both English and French surveys to the 94 abortion facilities identified.
Medical abortion represented only 3.8 percent of first-trimester abortions. Among facilities offering medical abortions, 45 percent performed fewer than 500 first-trimester abortions a year, while 35 percent performed more than 1000. More medical abortions were performed in private offices or ambulatory health centers than in hospitals. More than 75 percent of physicians performing medical abortions were female and 56.5 percent were family physicians. More than 85 percent of providers offered methotrexate with misoprostol. More than 90 percent required patients to have an ultrasound before the medical abortion and 72.6 percent used ultrasound to assess the completion of the abortion.
In Canada, medical abortion provision using methotrexate and misoprostol is consistent with best-practice guidelines. Medical abortion is rare and its availability is unevenly distributed.
The objective of second study is to determine the location of Canadian abortion services relative to where reproductive-age women reside as well as the characteristics of abortion facilities and providers. The research team used public sources and professional networks to identify abortion facilities across Canada. After adapting an international survey for relevance to Canada, the team sent both English and French surveys to the 94 abortion facilities identified.
Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centers and rural locations throughout the provinces. In other provinces, services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey.
The research team concluded that access to abortion services varied by region across Canada and are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion provision.
First study: http://www.cfp.ca/content/62/4/e201.full.pdf+html
Second study: http://www.cfp.ca/content/62/4/e209.full.pdf+html