Medical abortion services: an argument for expansion to primary care

  • Beaman J & al.
  • N Engl J Med
  • 17 abr. 2019

  • de Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Primary care physicians can expand abortion care access by providing medical abortions, argue the authors of this editorial.

Why this matters

  • 600,000 pregnancies result in abortion each year in the United States.
  • Barriers to abortion are increasing, disproportionately affecting women with fewer resources.

Key highlights

  • The US Department of Health and Human Services published a final rule on March 4, to go into effect on May 3, 2019, providing updated regulations for providers participating in the Title X family planning program.
  • Title X was designed to ensure comprehensive contraceptive care and preventive health services access, especially for low-income/uninsured people.
  • The new rule requires "clear financial and physical separation" between projects and programs funded by Title X and "facilities where abortion is a method of family planning."
  • Title X providers cannot "refer for abortion (even when requested by a client)" or require providers offer abortion counseling.
  • Title X has never been used to pay for abortion services, but the rule will effectively prevent Title X patients from obtaining abortion-related information, counseling, and services.
  • To counteract new barriers, these authors suggest that primary care physicians should be trained to administer medical abortions.

Study design

  • Editorial.
  • Funding: None disclosed.