Obstetrician-gynecologists’ practices related to LARC and abortion: A national survey
Awarded 2014
Large Research Grants
Daniel Grossman, MD
Ibis Reproductive Health

Objectives: A 2008-2009 national survey estimated that 14% of obstetrician-gynecologists provide abortion care. We aimed to update this estimate and document barriers to provision. Methods: In 2016-2017, we performed a survey with a representative sample of Fellows of the American College of Obstetricians and Gynecologists. The survey was sent by email with an online link, and non-responders were mailed paper surveys. Descriptive statistics and chi-square and logistic regression analyses were performed. Results: 1,280 currently practicing Fellows responded to the survey (response rate 54%). 99% reported seeing patients of reproductive age, and 69% reported having a patient in the prior year who needed or wanted an abortion. 1,128 were included in this analysis. 24% (95% CI 21%-26%) reported performing an abortion in the prior year; 10% provided surgical and medical abortion, 9% surgical only, and 4% medical only. In multivariable analysis, physicians living in the Northeast or West (versus South), those in a university faculty practice (versus partnership/group practice) and those in urban areas (versus midsize town/rural/military) had significantly higher odds of providing abortion. Age and gender were not associated with provision. The most common reasons for not providing abortion were personal beliefs (20%) and practice restrictions (10%). Among those not providing medical abortion, 19% said they would if they could write a prescription for mifepristone; 18% said they were unsure. Conclusions: Abortion provision may be increasing among practicing obstetrician-gynecologists since the last national survey, although important geographic disparities exist. Few provide medical abortion alone, but uptake might increase if mifepristone could be prescribed.