Regina M Renner, MD, MPH, FRCSC, FACOG, of the Contraception and Abortion Research Team and Clinical Associate Professor in the Department of Obstetrics and Gynecology at the University of British Columbia in Vancouver and his colleagues conducted the survey research. The 2019 national survey, which was conducted in English and French, was anonymized and collected in a web-based format. “Between July and December 2020, we distributed the survey through professional organizations, including the College of Family Physicians of Canada and the Society of Obstetricians and Gynecologists of Canada,” the authors said. The researchers collected data on clinical care and demographics of nurse practitioners and physicians.
Renner et al.’s analysis included 465 responses from the 10 provinces and 3 territories.1 The researchers said that 83.4% (388) performed medical abortions in the 1st trimester, including 30 nurse practitioners. Of these medical abortions, 99.4% (350) involved the use of mifepristone.1
“Two hundred and nineteen (47.1%) respondents performed a surgical abortion in the first trimester, 109 (23.4%) performed a surgical abortion in the second trimester, and 115 (24.7%) performed a medical abortion in the second or third trimester,” Renner and colleagues reported.1
A total of 48,509 abortions were reported in the survey in 2019.1 Of these, 66.7% (32,345) were first trimester surgical abortions and 27.7% (13,429) were first trimester medical abortions1. abortions,” Renner and colleagues noted. The researchers said primary care providers performed most abortions (34,540/71.2%).1 “First-trimester medical abortions accounted for 44.4% (n=2334) of all abortions in rural areas, compared to 25.6% (n=11067) in urban areas,” the authors write.
Study Co-Author Madeline Ennis, PhD, Faculty of Medicine Research Associate, Department of Obstetrics and Gynecology, University of British Columbia BC Women’s Hospital, Women’s Health Research Institute in Traditional Musqueam Territory , Squamish and Tsleil-Waututh spoken with Contemporary OB/GYN® on research investigation. She said the most important finding of this study for providers in practice is that the survey found an increase in the availability of first-trimester medical abortions to 27%, making it easier to access the abortion, especially in rural areas. “Abortions were increasingly being performed in primary care and office settings, rather than primarily by specialists or in dedicated abortion centers,” she said, adding that nurse practitioners were routinely providing independent of medical abortion services in the first trimester. “Half of our respondents reported having less than 5 years of experience in abortion care, suggesting a rejuvenating workforce, which is a key contributor to equitable access to abortion services “, Ennis said.
Ennis noted that what was most significant about this particular study is that it was a national survey of medical and surgical abortion providers and the first since mifepristone became available. in Canada in 2017. added.
Ennis said the investigation is now complete and researchers are publishing the results. “We will continue to share the results of our research with our national collaborators, including provincial governments and health professional organizations. This will include evidence briefs and virtual meetings, health professional development and contributing to updated clinical practice guidelines,” she said.
Ennis added that for health care providers in Canada who want to offer first-trimester medical abortion care or learn more, the Society of Obstetricians and Gynecologists of Canada has published detailed guidelines.2.3 “There are also support platforms and information available through the Canadian Abortion Provider Support Community and the National Abortion Federation of Canada,” she said.4.5
Further information on the survey, including additional publications, is listed on the website at: https://cart-grac.ubc.ca/caps-2019/.
- Renner RM, Ennis M, Contandriopoulos D, et al. Abortion services and providers in Canada in 2019: results from a national survey. CMAJ Open. 2022;10(3):E856-E864. September 27, 2019. doi:10.9778/cmajo.20210232.
- Costescu D, Guilbert E, Bernardin J, et al. Medical abortion. Journal of Obstetrics and Gynecology Canada:2016;38:366-89.
- Guilbert E, Costescu D, Wagner MS, et al. Canadian Protocol for the Provision of Medical Abortion by Telemedicine. SOGC COVID-19 Resources. Canada: Society of Obstetricians and Gynecologists of Canada. 2020.
- CAPS Forum CPCA. https://caps-cpca.ubc.ca/index.php?title=Main_Page. Published April 8, 2021. Accessed October 7, 2022.
- NAF Canada Home. National Abortion Federation Canada. https://nafcanada.org/. Accessed October 7, 2022.