Women's Health Issues
Volume 16, Issue 1 , Pages 14-21 , January 2006

Determinants of physician unwillingness to offer medical abortion using mifepristone

  • Michelle D. Seelig, MD, MSHS

      Affiliations

    • David Geffen School of Medicine at UCLA, Department of Family Medicine, Los Angeles, California
    • Corresponding Author InformationCorrespondence to: Michelle D. Seelig, MD, MSHS, National Research Service Award Fellow, David Geffen School of Medicine at UCLA, Department of Family Medicine, 10880 Wilshire Blvd, Suite 1800, Los Angeles, California 90024-4142
  • ,
  • Lillian Gelberg, MD, MSPH

      Affiliations

    • David Geffen School of Medicine at UCLA, Department of Family Medicine, Los Angeles, California
  • ,
  • Paula Tavrow, PhD

      Affiliations

    • UCLA School of Public Health, Community Health Sciences Department, Los Angeles, California, USA
  • ,
  • Martin Lee, PhD

      Affiliations

    • UCLA School of Public Health, Department of Biostatistics, Los Angeles, California, USA
    • VA Greater Los Angeles HSR&D Center of Excellence, Center for the Study of Healthcare Provider Behavior, Sepulveda, California, USA
  • ,
  • Lisa V. Rubenstein, MD, MSPH

      Affiliations

    • VA Greater Los Angeles HSR&D Center of Excellence, Center for the Study of Healthcare Provider Behavior, Sepulveda, California, USA
    • David Geffen School of Medicine at UCLA, Department of Internal Medicine, Los Angeles, California, USA

Received 22 October 2004 ,Revised 4 May 2005 ,Accepted 3 October 2005.

References 

  1. Abma JC , Chandra A , Mosher WD , Peterson LS , Piccinino LJ . Fertility, family planning, and women’s health (New data from the 1995 national survey of family growth) . Vital Health Statistics . 1997;23(19):1–114
  2. Alan Guttmacher Institute (AGI). (2005). Facts in brief: Induced abortion. Available: http://www.agi-usa.org/pubs/fb_induced_abortion.html. Accessed April 13, 2005.
  3. Alan Guttmacher Institute (AGI). (2004). Annual report planned parenthood. Available: http://www.lifeissues.org/pp/report-04.pdf. Accessed April 13 2005.
  4. Alan Guttmacher Institute (AGI). (2005). Facts in brief: Induced abortion in the United States. Accessed October 21, 2005.
  5. Andreasen A . Marketing social change (Changing behavior to promote health, social development, and the environment) . San Francisco: Jossey-Bass; 1995;
  6. Ashok PW , Penney GC , Flett GM , Templeton A . An effective regimen for early medical abortion (A report of 2000 consecutive cases) . Human Reproduction . 1998;13:2962–2965
  7. Barfield W . Racial/ethnic trends in fetal mortality—United States, 1990–2000 . Surveillance Summaries (Morbidity and Mortality Weekly Report) . 2004;53:529–532
  8. Beckman LJ , Harvey SM , Satre SJ . The delivery of medical abortion services (The views of experienced providers) . Womens Health Issues . 2002;12:103–112
  9. Christin-Maitre S , Bouchard P , Spitz IM . Medical termination of pregnancy . New England Journal of Medicine . 2000;342:946–956
  10. Clark S , Ellertson C , Winikoff B . Is medical abortion acceptable to all American women (The impact of sociodemographic characteristics on the acceptability of mifepristone-misoprostol abortion) . Journal of the American Medical Women’s Association . 2000;55(3 Suppl):177–182
  11. Elam-Evans LD , Strauss LT , Herndon J , Parker WY , Bowens SV , Zane S , et al.   Abortion surveillance—United States, 2000 . Surveillance Summaries (Morbidity and Mortality Weekly Report) . 2003;52(12):1–32
  12. Ellertson C , Simonds W , Winikoff B , Springer K , Bagchi D . Providing mifepristone-misoprostol medical abortion (The view from the clinic) . Journal of the American Medical Women’s Association . 1999;54:91–96
  13. Elul B , Pearlman E , Sorhaindo A , Simonds W , Westhoff C . In-depth interviews with medical abortion clients (Thoughts on the method and home administration of misoprostol) . Journal of the American Medical Women’s Association . 2000;55(3 Suppl):169–172
  14. FDA . Labeling changes for mifepristone . FDA Consumer . 2005;39(1):5
  15. Finer LB , Henshaw SK . Abortion incidence and services in the United States in 2000 . Perspectives on Sexual and Reproductive Health . 2003;35:6–15
  16. Grier S , Bryant CA . Social marketing in public health . Annual Review of Public Health . 2005;26:319–339
  17. Grimes DA . Medical abortion (Public health and private lives) . American Journal of Obstetrics and Gynecology . 2000;183(2 Suppl):S1–S2
  18. Grimes DA , Creinin MD . Induced abortion (An overview for internists) . Annals of Internal Medicine . 2004;140:620–626
  19. Harvey SM , Beckman LJ , Satre SJ . Experiences and satisfaction with providing methotrexate-induced abortions among U.S. providers . Journal of the American Medical Women’s Association . 2000;55(3 Suppl):161–163
  20. Harvey SM , Beckman LJ , Satre SJ . Choice of and satisfaction with methods of medical and surgical abortion among U.S. Clinic patients . Family Planning Perspectives . 2001;33:212–216
  21. Hausknecht R . Mifepristone and misoprostol for early medical abortion (18 months experience in the United States) . Contraception . 2003;67:463–465
  22. Henshaw S , Finer L . The accessibility of abortion services in the U.S. . Perspectives on Sexual and Reproductive Health . 2003;35:16–24
  23. Joffe C . Reactions to medical abortion among providers of surgical abortion (An early snapshot) . Family Planning Perspectives . 1999;31:35–38
  24. Joffe C . Medical abortion in social context . American Journal of Obstetrics and Gynecology . 2000;183(Suppl 2):S10–S15
  25. Joffe C , Weitz TA . Normalizing the exceptional (Incorporating the “abortion pill” into mainstream medicine) . Social Sciences & Medicine . 2003;56:2353–2366
  26. Jones RK , Henshaw SK . Mifepristone for early medical abortion (Experiences in France, Great Britain and Sweden) . Perspectives on Sexual and Reproductive Health . 2002;34:154–161
  27. Kahn JG , Becker BJ , MacIsaa L , Amory JK , Neuhaus J , Olkin I , et al.   The efficacy of medical abortion (A meta-analysis) . Contraception . 2000;61:29–40
  28. Koenig JD , Tapias MP , Hoff T , Stewart FH . Are U.S. health professionals likely to prescribe mifepristone or methotrexate? . Journal of the American Medical Women’s Association . 2000;55(Suppl 3):155–160
  29. Kulier R , Gulmezoglu AM , Hofmeyr GJ , Cheng LN , Campana A . Medical methods for first trimester abortion . Cochrane Database of Systematic Reviews . 2004; (2), CD002855
  30. Lukacs S , Schoendorf K . Racial/ethnic disparities in neonatal mortality—United States, 1989–2001 . Surveillance Summaries (Morbidity and Moratlity Weekly Reports) . 2004;53:655–658
  31. Murthy A , Creinin MD . Pharmacoeconomics of medical abortion (A review of cost in the United States, Europe and Asia) . Expert Opinion on Pharmacotherapy . 2003;4:503–513
  32. Newhall EP , Winikoff B . Abortion with mifepristone and misoprostol (Regimens, efficacy, acceptability and future directions) . American Journal of Obstetrics and Gynecology . 2000;183(2 Suppl):S44–S53
  33. Phares TM , Morrow B , Lansky A , Barfield WD , Prince CB , Marchi KS , et al.   Surveillance for disparities in maternal health-related behaviors—Selected states, pregnancy risk assessment monitoring system (prams), 2000–2001 . Surveillance Summaries (Morbidity and Mortality Weekly Reports) . 2004;53(4):1–13
  34. Prine L , Lesnewski R , Berley N , Gold M . Medical abortion in family practice (A case series) . Journal of the American Board of Family Practice . 2003;16:290–295
  35. Prochaska JO , Redding CA , Evers KE . The transtheoretical model and stages of change . In:  Glanz K ,  Rimer BK ,  Lewis FM editor. Health behavior and health education . 3rd ed.. San Francisco: Jossey-Bass; 2002;p. 99–120
  36. Rogers EM . Diffusion of innovation . 3rd ed.. New York: The Free Press; 1983;
  37. Rubenstein LV , Mittman BS , Yano EM , Mulrow CD . From understanding health care provider to improving health care . Medical Care . 2000;38:I129–I141
  38. Schaff EA , Eisinger SH , Stadalius LS , Franks P , Gore BZ , Poppema S . Low-dose mifepristone 200 mg and vaginal misoprostol for abortion . Contraception . 1999;59:1–6
  39. Schaff EA , Fielding SL . A comparison of the abortion rights mobilization and population council trials . Journal of the American Medical Women’s Association . 2000;55(Suppl 3):137–140
  40. Schaff EA , Fielding SL , Westhoff C . Randomized trial of oral versus vaginal misoprostol at one day after mifepristone for early medical abortion . Contraception . 2001;64:81–85
  41. Schaff EA , Fielding SL , Westhoff C . Randomized trial of oral versus vaginal misoprostol 2 days after mifepristone 200 mg for abortion up to 63 days of pregnancy . Contraception . 2002;66:247–250
  42. Schwarz EB , Luetkemeyer A , Foster DG , Weitz TA , Lindes D , Stewart FH . Willing and able? Provision of medication for abortion by future internists . Womens Health Issues . 2005;15:39–44
  43. Simonds W , Ellertson C , Springer K , Winikoff B . Abortion, revised (Participants in the U.S. Clinical trials evaluate mifepristone) . Social Science & Medicine . 1998;46:1313–1323
  44. Spitz IM , Bardin CW , Benton L , Robbins A . Early pregnancy termination with mifepristone and misoprostol in the United States . New England Journal of Medicine . 1998;338:1241–1247
  45. World Health Organization (WHO) . Termination of pregnancy with reduced doses of mifepristone (World health organisation task force on post-ovulatory methods of fertility regulation) . BMJ . 1993;307(6903):532–537
  46. World Health Organization (WHO) . Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion (A randomised trial. World health organisation task force on post-ovulatory methods of fertility regulation) . British Journal of Obstetrics and Gynaecology . 2000;107:524–530
  47. Winikoff B . Pregnancy failure and misoprostol—time for a change . New England Journal of Medicine . 2005;353:834–836
  48. Winikoff B , Ellertson C , Elul B , Sivin I . Acceptability and feasibility of early pregnancy termination by mifepristone-misoprostol. Results of a large multicenter trial in the United States. Mifepristone clinical trials group . Archives of Family Medicine . 1998;7:360–366

 Supported by a National Research Service Award and the Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Service (Project #HFP 94-028) in collaboration with the Office of Academic Affiliations, VA Women’s Health Fellowship Program. The views expressed in this article are those of the authors and do not necessarily represent the views of the University of California Departments of Medicine, Family Medicine or Public Health or the Department of Veterans Affairs.

PII: S1049-3867(05)00109-X

doi: 10.1016/j.whi.2005.12.001

Women's Health Issues
Volume 16, Issue 1 , Pages 14-21 , January 2006