"She's on her own": a thematic analysis of clinicians' comments on abortion referral.

Abstract:

OBJECTIVE:The objective was to understand the motivations around and practices of abortion referral among women's health providers. METHODS:We analyzed the written comments from a survey of Nebraska physicians and advanced-practice clinicians in family medicine and obstetrics-gynecology about their referral practices and opinions for a woman seeking an abortion. We analyzed clinician's responses to open-ended questions on abortion referral thematically. RESULTS:Of the 496 completed surveys, 431 had comments available for analysis. We found four approaches to abortion referral: (a) facilitating a transfer of care, (b) providing the abortion clinic name or phone number, (c) no referral and (4) misleading referrals to clinicians or facilities that do not provide abortion care. Clinicians described many motivations for their manner of referral, including a fiduciary obligation to refer, empathy for the patient, respect for patient autonomy and the lack of need for referral. We found that abortion stigma impacts referral as clinicians explained that patients often desire additional privacy and clinicians themselves seek to avoid tension among their staff. Other clinicians would not provide an abortion referral, citing moral or religious objections or stating they did not know where to refer women seeking abortion. Some respondents would refer women to other providers for additional evaluation or counseling before an abortion, while others sought to dissuade the woman from obtaining an abortion. CONCLUSIONS:While practices and motivations varied, few clinicians facilitated referral for abortion beyond verbally naming a clinic if an abortion referral was made at all. IMPLICATIONS:Interprofessional leadership, enhanced clinician training and public policy that addresses conscientious refusal of abortion referral are needed to reduce abortion stigma and ensure that women can access safe care.

journal_name

Contraception

journal_title

Contraception

authors

Homaifar N,Freedman L,French V

doi

10.1016/j.contraception.2017.01.007

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

470-476

issue

5

eissn

0010-7824

issn

1879-0518

pii

S0010-7824(17)30013-6

journal_volume

95

pub_type

杂志文章
  • A randomized comparative study of the performance of seven different sizes of the Mahua Ring inserted following measurement of the uterine cavity and one size of the same ring.

    abstract::A comparative study of the performance of multi-sizes of the Mahua Ring inserted following measurement of the uterine cavity and one size of the same ring assigned at random was carried out from November 1984 to September 1985 at two hospitals in Tianjin. The experiences of 800 acceptors were analysed by life-table te...

    journal_title:Contraception

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/0010-7824(90)90048-z

    authors: Juan QL,Zhi LJ,Juan SL,Yi WM,Wu GM

    更新日期:1990-10-01 00:00:00

  • A prospective, non-randomized study of home use of mifepristone for medical abortion in the U.S.

    abstract:OBJECTIVE:To determine the acceptability of taking mifepristone at home for early medical abortion in the United States. STUDY DESIGN:This prospective, non-randomized, open-label study at six Planned Parenthood centers gave women with pregnancies up to 63 days' gestation seeking medical abortion the choice of taking m...

    journal_title:Contraception

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1016/j.contraception.2015.06.026

    authors: Chong E,Frye LJ,Castle J,Dean G,Kuehl L,Winikoff B

    更新日期:2015-09-01 00:00:00

  • Blood levels of ethynylestradiol, caffeine, aldosterone and desoxycorticosterone in hypertensive oral contraceptive users.

    abstract::Twenty normotensive and ten hypertensive black women taking oral contraceptive (OC) were studied. Age, body weight, family medical history of hypertension, length of OC use, and type of OC were comparable. At midcycle approximately 10-12 hours following OC intake, blood was drawn and the plasma was used to determine e...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/s0010-7824(81)80006-6

    authors: Kaul L,Curry CL,Ahluwalia BS

    更新日期:1981-06-01 00:00:00

  • Use of multiple clips for tubal occlusion in interval laparoscopic sterilization: circumstances and consequences.

    abstract::The use of multiple clips for the occlusion of the Fallopian tubes has been reported in interval laparoscopic sterilization, but the circumstances leading to the performance of the multiple-clip procedure and its effects on safety and efficacy have not been carefully studied. A data set from international multi-center...

    journal_title:Contraception

    pub_type: 临床试验,杂志文章

    doi:10.1016/0010-7824(94)90058-2

    authors: Chi IC

    更新日期:1994-11-01 00:00:00

  • Increasing access to safe abortion services in rural India: experiences with medical abortion in a primary health center.

    abstract:INTRODUCTION:To increase access to safe abortion in rural India, the feasibility and acceptability of mifepristone-misoprostol abortion was assessed in a typical government run primary health center (PHC) in Nagpur district, Maharashtra State, that does not offer surgical abortion services and must refer off-site for e...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2007.03.010

    authors: Mundle S,Elul B,Anand A,Kalyanwala S,Ughade S

    更新日期:2007-07-01 00:00:00

  • Plasma concentrations of free and non-TeBG bound testosterone in women on oral contraceptives.

    abstract::Differential precipitation of plasma proteins after equilibration of the plasma with tracer amounts of testosterone (T) was used to measure free and not-T-estradiol binding globulin (TeBG)-bound T in 20 women and 10 men. Tritiated T was the tracer used. Comparison of this method with the equilibration dialysis metho...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(74)90099-7

    authors: Tremblay RR,Dube JY

    更新日期:1974-12-01 00:00:00

  • Effects of oral contraceptives containing 50 microgram estrogen on blood coagulation in non-Caucasian women.

    abstract::In one of the first longitudinal studies of 163 non-Caucasian women, comprehensive coagulation, fibrinolysis and platelet function tests were performed before and during 24 months of oral contraceptive pill usage containing 50 microgram estrogen. Results of this ongoing study indicate a state of abnormal coagulability...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(80)90015-3

    authors: Tsakok FH,Koh S,Ratnam SS

    更新日期:1980-05-01 00:00:00

  • Music as an auxiliary analgesic during first trimester surgical abortion: a randomized controlled trial.

    abstract:BACKGROUND:Music has served as an auxiliary analgesic in perioperative settings. This study evaluates the impact of intraoperative music added to routine pain control measures during first trimester surgical abortion. STUDY DESIGN:We analyzed data from 101 women randomized to undergo abortion with routine pain control...

    journal_title:Contraception

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.contraception.2011.11.017

    authors: Guerrero JM,Castaño PM,Schmidt EO,Rosario L,Westhoff CL

    更新日期:2012-08-01 00:00:00

  • Women's out-of-pocket expenditures and dispensing patterns for oral contraceptive pills between 1996 and 2006.

    abstract:BACKGROUND:Little is known about the out-of-pocket expenditures and dispensing patterns for oral contraceptive pills (OCPs), factors associated with these outcomes and whether they change over time. STUDY DESIGN:Observational cohort using 1996-2006 Medical Expenditure Panel Surveys. RESULTS:Women spent $16 out-of-poc...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2010.09.013

    authors: Liang SY,Grossman D,Phillips KA

    更新日期:2011-06-01 00:00:00

  • Interest in and experience with IUD self-removal.

    abstract:OBJECTIVES:In the United States, the popularity of intrauterine devices (IUDs) is low despite many positive attributes such as high effectiveness and ease of use. The requirement that a clinician remove the IUD may limit US women's interest in the method. Our objective was to describe women's experience with self-remov...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2014.01.025

    authors: Foster DG,Grossman D,Turok DK,Peipert JF,Prine L,Schreiber CA,Jackson AV,Barar RE,Schwarz EB

    更新日期:2014-07-01 00:00:00

  • Trends in nonresident abortion rates in New York City from 2005 to 2015: a time series analysis.

    abstract:OBJECTIVES:To examine trends and utilization patterns of NYC abortion services by nonresidents since growing abortion restrictions across many states could drive women to seek care in less restrictive jurisdictions including NYC. STUDY DESIGN:We used data from Induced Termination of Pregnancy certificates filed with t...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2019.05.008

    authors: Johansson EW,Argov EL,Langston A,Yager A,Searing H,Liu SY

    更新日期:2019-09-01 00:00:00

  • Changing disparities in teen birth rates and repeat birth rates in Georgia: implications for teen pregnancy prevention.

    abstract:OBJECTIVE:To understand teen birth trends in Georgia by racial and geographic factors. STUDY DESIGN:We analyzed overall birth and repeat teen birth rates by race, urban/rural status and adequacy of obstetric care from 2008 to 2016 using vital records from all Georgia counties. RESULTS:Overall birth rates among teens ...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2018.11.007

    authors: Nandi P,Kramer M,Kottke M

    更新日期:2019-03-01 00:00:00

  • A morphometric study of the effect of oral norethisterone or levonorgestrel on endometrial blood vessels.

    abstract::A morphometric study was undertaken to quantitate vessel numbers in uterine biopsies from a control group of patients, patients with dysfunctional uterine bleeding and patients taking low dose norethisterone or levonorgestrel. Vessels were counted at the endometrial/myometrial junction and in the functional endometriu...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/s0010-7824(86)80016-6

    authors: Hourihan HM,Sheppard BL,Bonnar J

    更新日期:1986-12-01 00:00:00

  • Steroid contraceptives in non-human primates (II). Metabolic fate of synthetic estrogens in the baboon after exposure to oral contraceptives.

    abstract::The metabolism of isotopically labeled ethinyl estradiol (EE) and mestranol (ME) was studied in 3 baboons before and after the simultaneous injection of a norethindrone-mestranol contraceptive formulation. 6 days after the administration of tritiated-EE and carbon-14-ME, the mean urinary excretion of labeled-EE was 3...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(77)90116-0

    authors: Kulkarni BD,Avila TD,O'Leary JA

    更新日期:1977-03-01 00:00:00

  • Release of 19-nor-testosterone type of contraceptive steroids through different drug delivery systems into serum and breast milk of lactating women.

    abstract::The release of contraceptive steroids through different drug delivery systems into serum and breast milk was investigated in a group of lactating women. Four women in each group were taking either a low dosage progestogen compound like norethisterone (NET) 350 micrograms or d-norgestrel (d-Ng) 50 micrograms alone or l...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(80)90002-5

    authors: Toddywalla VS,Mehta S,Virkar KD,Saxena BN

    更新日期:1980-03-01 00:00:00

  • How women anticipate coping after an abortion.

    abstract:BACKGROUND:There has been some study of women's emotional and psychological well-being after an abortion but no research into women's expectations, at the time of seeking an abortion, of how they will cope after the abortion. STUDY DESIGN:We abstracted counseling needs assessment forms of 5109 women who sought an abor...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2011.11.002

    authors: Foster DG,Gould H,Kimport K

    更新日期:2012-07-01 00:00:00

  • Oral contraceptives and venous thromboembolism: a five-year national case-control study.

    abstract::The objective of this study was to assess the influence of oral contraceptives (OCs) on the risk of venous thromboembolism (VTE) in young women. A 5-year case-control study including all Danish hospitals was conducted. All women 15-44 years old, suffering a first ever deep venous thrombosis or a first pulmonary emboli...

    journal_title:Contraception

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0010-7824(01)00307-9

    authors: Lidegaard Ø,Edström B,Kreiner S

    更新日期:2002-03-01 00:00:00

  • Inhibition of Chlamydia trachomatis growth in endometrial cells by copper: possible relevance for the use of the copper IUD.

    abstract::There is agreement that the relative risk of developing pelvic inflammatory disease (PID) increases among women who use the intrauterine contraceptive device (IUD). The role of Chlamydia in causing PID among IUD users is not clear. The present study demonstrates that Chlamydia trachomatis growth can be inhibited in cu...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(89)90041-3

    authors: Kleinman D,Sarov I,Insler V

    更新日期:1989-06-01 00:00:00

  • Mechanism of action of intrauterine devices: biochemical changes.

    abstract::The mechanism of action of intrauterine devices varies from one type of device to another, although the principle of action is the same, namely, to interfere with the physiology of reproduction at the endometrial level. The biochemical changes of the endometrial tissue and the composition of the uterine fluid have bee...

    journal_title:Contraception

    pub_type: 杂志文章,评审

    doi:10.1016/0010-7824(87)90058-8

    authors: Johannisson E

    更新日期:1987-07-01 00:00:00

  • Progestin-only pill use over 6 months postpartum.

    abstract:OBJECTIVES:To determine progestin-only pill (POP) use at 3 and 6 months postpartum among women who chose POPs at the postpartum visit. STUDY DESIGN:Secondary data analysis of a prospective observational study with telephone interviews at 3 and 6 months postpartum to assess contraceptive use. RESULTS:Of 440 women who ...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2020.06.004

    authors: Uhm S,Garcia-Ruiz N,Creinin MD,Blanton A,Chen MJ

    更新日期:2020-10-01 00:00:00

  • Midtrimester abortion with intramuscular injection of 15-methyl-prostaglandin F2alpha.

    abstract::This study examines the efficacy and side effects of 15-methyl-prostaglandins F2alpha (PGF2a) free acid administered intramuscularly for midtrimester abortion. 50 healthy women aged 14 to 37 years and between 12 to 18 weeks gestation were randomly selected from the abortion clinic at the Los Angeles County/USC Medica...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(75)90107-9

    authors: Slaughter L,Ballard CA

    更新日期:1975-05-01 00:00:00

  • Menstrual blood loss estimates in women using copper 7 and multiload-250 intrauterine devices.

    abstract::An estimate of the menstrual blood loss (MBL) in 29 women using the Cu-7 and in 33 women using the ML-250 IUDs was carried out. None of the women who took part in the study used hormonal contraceptives or IUDs for six months previous to the study. Before the insertion of the IUD, the MBL of each woman was measured for...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(82)90146-9

    authors: Pedrón N,Gallegos AJ,Lozano M,Aznar R

    更新日期:1982-11-01 00:00:00

  • Tamoxifen as an antifertility agent in the long-tailed macaque (Macaca fascicularis).

    abstract::The potential use of tamoxifen, a nonsteroidal antiestrogen, as an antifertility agent was studied in the long-tailed macaque (Macaca fascicularis). Twenty-six cycling females were bred, then treated with a single oral dose of tamoxifen (5 mg/kg) (N = 13) or vehicle (N = 13) on day 4 post-ovulation. Serum progesterone...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(93)90047-b

    authors: Tarantal AF,Hendrickx AG,Matlin SA,Lasley BL,Gu QQ,Thomas CA,Vince PM,Van Look PF

    更新日期:1993-03-01 00:00:00

  • Sociocultural and religious influences on the normative contraceptive practices of Latino women in the United States.

    abstract::Presumably, Latino women engage in little family planning because of religious or cultural objections to contraception. The purpose of this study was to examine how acculturation, religion and various demographic factors were related to the family-planning behaviors of Latino women in the United States. Data were coll...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2003.10.011

    authors: Romo LF,Berenson AB,Segars A

    更新日期:2004-03-01 00:00:00

  • Long-term assessment of symptomatology and satisfaction of an extended oral contraceptive regimen.

    abstract:OBJECTIVE:The study was conducted to assess hormone withdrawal symptoms, patient acceptance and occurrence and management of bleeding with an extended oral contraceptive (OC) regimen. METHODS:Subjects were placed on an OC containing 3 mg drosperinone (DRSP) and 30 microg ethinyl estradiol (EE), in the standard 21/7 fa...

    journal_title:Contraception

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.contraception.2007.01.014

    authors: Coffee AL,Sulak PJ,Kuehl TJ

    更新日期:2007-06-01 00:00:00

  • Abortion referral patterns among generalist OB/GYNs and primary care practitioners: A qualitative study.

    abstract:OBJECTIVE:An informed, timely referral from a generalist practitioner has the potential to facilitate care for a patient seeking an abortion. However it is unclear what barriers, if any, generalist practitioners perceive in this process. The objective of this study was to qualitatively characterize abortion referral pa...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2019.10.009

    authors: Linton A,Mendez SR,Simon MA

    更新日期:2020-02-01 00:00:00

  • The effects of 2 mg chlormadinone acetate/30 mcg ethinylestradiol, alone or combined with spironolactone, on cardiovascular risk markers in women with polycystic ovary syndrome.

    abstract:BACKGROUND:Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with metabolic dysfunction and changes in cardiovascular risk markers, and using oral contraceptives (OCs) may exert a further negative effect on these alterations in patients with PCOS. Thus, the primary objective of this study was to asse...

    journal_title:Contraception

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.contraception.2011.12.011

    authors: Vieira CS,Martins WP,Fernandes JB,Soares GM,dos Reis RM,de Sá MF,Ferriani RA

    更新日期:2012-09-01 00:00:00

  • Oral contraceptive steroids do not promote the development or growth of prolactinomas.

    abstract::Seventy women with prolactinomas, age 19-38 years, were studied in order to evaluate a possible relationship between the use of steroidal oral contraceptives (o.c.) and the development of prolactin-producing adenomas. Sixty-seven patients were admitted for investigation because of menstrual bleeding disturbances and t...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/0010-7824(83)90057-4

    authors: Hulting AL,Werner S,Hagenfeldt K

    更新日期:1983-01-01 00:00:00

  • Prevalence of visible disruption of cervical epithelium and cervical ectopy in African women using Depo-Provera.

    abstract::Associations between Depo-Provera (injectable, progesterone-only contraceptive) use and visible disruption of cervical epithelium and cervical ectopy were investigated using data collected as part of a cervical cancer screening study in periurban Cape Town, South Africa. Women were interviewed about their contraceptiv...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/s0010-7824(99)00049-9

    authors: Kuhn L,Denny L,Pollack AE,Wright TC

    更新日期:1999-06-01 00:00:00

  • Associations of mental illness and substance use disorders with prescription contraception use among women veterans.

    abstract:OBJECTIVE:To investigate whether mental illness and substance use disorder (SUD) are associated with having a prescription contraceptive method among women veterans. STUDY DESIGN:We conducted a retrospective analysis of National Veterans Administration (VA) administrative and clinical data for women veterans aged 18-4...

    journal_title:Contraception

    pub_type: 杂志文章

    doi:10.1016/j.contraception.2014.02.028

    authors: Callegari LS,Zhao X,Nelson KM,Lehavot K,Bradley KA,Borrero S

    更新日期:2014-07-01 00:00:00