This qualitative study examines how U.S. internal medicine physicians have successfully integrated medication abortion (MAB) into primary care practices. Rather than focusing on previously well-described barriers, this research takes a strengths-based approach.
Despite medication abortions now comprising over 60% of all abortions in the US, most are still provided by family medicine physicians or OBGYNs—specialties with more intrauterine procedural training than internal medicine. Although internists routinely provide primary care to women of reproductive age and many have expressed interest in offering abortion care, few have successfully done so. Beyond the logistical and political barriers facing all potential abortion providers, internists encounter limited training opportunities and a prevailing medical culture that views abortion as outside internal medicine’s scope of practice.
This study will interview 10-20 internal medicine primary care physicians who have successfully implemented MAB in their practices. We will conduct semi-structured interviews grounded in the EPIS implementation science framework. Given the sensitive nature of this topic and the limited number of eligible physicians nationwide, we will use snowball sampling to identify potential participants, supplemented by recruitment through relevant national professional associations including the Society for General Internal Medicine and the Reproductive Health Access Project.
Interviews will be transcribed, coded, and analyzed thematically to understand how individual internists achieved MAB implementation. Findings will inspire internists who aspire to provide MABs while providing concrete strategies for overcoming barriers. Results will be disseminated to interested internists and shared with organizations that have produced existing MAB implementation toolkits to collaboratively expand resources.