New Study Finds Increases in Medical Abortion, but not Access

A new study within the journal medicine and medicine, conducted by researchers from the Guttmacher Institute, makes an attempt to quantify the supply of medication abortion (non-surgical abortion via the medication mifepristone/Mifeprex) within the U. S., and also the overlap between medication and surgical abortion suppliers. The authors make a case for that it had been hoped that the supply of this non-surgical choice would possibly increase abortion accessibility “because it may well be delivered a lot of in camera and while not surgical facilities, [and] offered by a wider vary of suppliers, like non-public obstetrician-gynecologists and family practitioners.”

The authors used sales information from the U.S. distributor of abortifacient and abortion police investigation information from the bureau and Guttmacher’s own surveys of abortion suppliers. victimization this informatiarticle-0-010D609A000004B0-198_468x466on, they tried to calculate the calculable numbers of abortifacient abortions and suppliers by year, supplier kind, and medico specialty, the proportion of all abortions and of eligible (i.e., early enough for the medication option) abortions that used abortifacient, and also the range of mifepristone-only suppliers UN agency were over fifty miles faraway from a known surgical supplier. [The researchers detail this method and their connected assumptions within the methods; statistics geeks can wish to urge a full copy of the paper for that information and their notes on the constraints.]

Among the findings:

  • Not astonishingly, the calculable range of medication abortions multiplied sharply within the years like a shot once the drug became obtainable, from regarding fifty five,000 in 2001 (the 1st full year of availability) to regarding 158,000 by 2007.
  • Based on existing trends, they estimate that antiabortion would represent seven-member of eligible abortions performed in 2000, and regarding twenty first in 2007 (an increase in share of all abortions from regarding four wheel drive in 2001 to 100% in 2007).
  • Provision of medication abortion tends to follow trends for provision of all abortion, with clinics providing the foremost, followed by physicians and hospitals. a lot of ob/gyns offer the drug than different physicians (such as family medicine or internal medicine) by a large margin.
  • Clinics, which usually provided surgical abortions moreover, accounted for half of one mile of antiabortion abortions, and ninety six were in metropolitan areas – “Only fourteen mifepristone-only suppliers were placed over fifty miles faraway from any surgical supplier. Solely 5 mifepristone-only suppliers of ten or a lot of abortions were placed farther than fifty miles from any surgical supplier of four hundred or a lot of abortions.” Fewer counties had a antiabortion supplier than had any doctorabortion supplier typically, and a lot of total abortion suppliers were calculable than antiabortion suppliers (meaning that some suppliers could provide surgical abortion only).

The authors conclude, therefore, that “The massive geographic overlap between facilities that offer surgical abortion and people that supply antiabortion means, in several cases, girls area unit ready to select the kind of early abortion procedure they like,” however that “mifepristone has not brought a serious improvement within the geographic accessibility of abortion.”

 

The study didn’t survey suppliers on why they may not provide medication abortion once surgical abortion is obtainable, why a lot of suppliers like family medicine physicians don’t appear to supply the drug, or why a lot of suppliers in areas with few or no surgical suppliers near don’t provide the drug as a matter of accessibility. The authors speculate that “One limiting issue could also be liability coverage, that has been known as a barrier to provision of abortion services typically, and antiabortion specifically, in family practice.” Another unexamined issue is that little share of ladies (5-8% per the drug label) victimization Mifeprex want a follow-up operation to complete the abortion or management bleeding; it’s not clear what impact this may need on suppliers UN agency don’t offer surgical abortions or in areas wherever those services don’t seem to be simply placed.