Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).

<h4>Background</h4>Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of Briti...

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Autores principales:	Wendy V Norman, Judith A Soon, Nanamma Maughn, Jennifer Dressler
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c25a663083c84617983a0d9b9c634594
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spelling	oai:doaj.org-article:c25a663083c84617983a0d9b9c6345942021-11-18T07:39:33ZBarriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).1932-620310.1371/journal.pone.0067023https://doaj.org/article/c25a663083c84617983a0d9b9c6345942013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23840578/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC).<h4>Methods</h4>We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews.<h4>Results</h4>Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence.<h4>Conclusions</h4>Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians.Wendy V NormanJudith A SoonNanamma MaughnJennifer DresslerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e67023 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wendy V Norman Judith A Soon Nanamma Maughn Jennifer Dressler Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
description	<h4>Background</h4>Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC).<h4>Methods</h4>We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews.<h4>Results</h4>Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence.<h4>Conclusions</h4>Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians.
format	article
author	Wendy V Norman Judith A Soon Nanamma Maughn Jennifer Dressler
author_facet	Wendy V Norman Judith A Soon Nanamma Maughn Jennifer Dressler
author_sort	Wendy V Norman
title	Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
title_short	Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
title_full	Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
title_fullStr	Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
title_full_unstemmed	Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).
title_sort	barriers to rural induced abortion services in canada: findings of the british columbia abortion providers survey (bcaps).
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/c25a663083c84617983a0d9b9c634594
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Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS).

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