Background: Expanding the pool of trained, competent medication abortion providers is necessary to fill gaps in access to safe abortion in the US. The scope of practice for advanced practice clinicians (APCs), including nurse practitioners (NPs), certified nurse midwives (CNMs) and physician assistants (PAs), extends well beyond the skills required to safely manage medication abortion ...Read more >

Background: Medical abortion with mifepristone and misoprostol is highly effective; however, continuing pregnancy can still occur, especially as gestation advances. Even after completing treatment, some women with continuing pregnancies change their mind. Legislators began to focus on women who change their mind after mifepristone administration following a 2012 report of “medical abortion reversal” in which ...Read more >

Background: Women are seeking abortion at increasingly earlier gestations which increases the likelihood that providers will have difficulty visualizing the pregnancy on ultrasound, the current standard of care in most abortion clinics in the US. Women with no gestational sac visualized on ultrasound have a pregnancy of unknown location (PUL). The most serious risk of ...Read more >

Background: New strategies are needed to help people overcome barriers to abortion and achieve greater reproductive autonomy. Demedicalized models for medication abortion care have the potential to greatly expand access to abortion, particularly for those most affected by distance and cost barriers. Methods: The study is a patient-centered, clinically supported, prospective observational study among people ...Read more >

Background: Current regulations restrict access to medication abortion and contribute to the perception that women cannot safely take medication abortion pills (mifepristone and misoprostol) on their own without clinician supervision. However, these drugs meet many of the Food and Drug Administration (FDA) criteria for being available over the counter (OTC). Medication abortion is safe, has ...Read more >

Background: While mifepristone has the potential to expand abortion access in the US through integration into primary care, initial expectations for provision by family physicians have not been realized. Research indicates that physician motivation to provide medication abortion is an important factor in overcoming logistical and organizational barriers to abortion provision. Methods: For this project, ...Read more >

Background: A rapid increase in legislation restricting access to clinical abortion services in the US has sparked renewed interest in self-managed abortion as a response to clinic access barriers. At the same time, rising interest in self-care and the role of the internet as a go-to source of goods and services raises the possibility that ...Read more >

Background: Mifepristone did not “revolutionize” access to abortion in the ways originally anticipated. However, in the 17 years since its approval it has changed the face of abortion care, potentially in ways that have increased access. In 2014, nearly-one third of abortions were early medication procedures, and 26% of clinic facilities provided only early medication ...Read more >

Background: The Mifeprex® Risk Evaluation and Mitigation Strategy (REMS) requires that the drug be dispensed only in a clinic, office, or hospital, despite the lack of evidence that this improves safety. In a recent survey of obstetrician-gynecologists (Ob-Gyns), we found that only 14% provided medication abortion, but an additional 15% said they would provide it ...Read more >

Background: While medication abortion has the potential to expand abortion access, barriers persist. One such barrier may be locating a provider. Research has shown that individuals commonly use the internet to self-refer for abortion services. However, we have previously shown that the quality of information available online for abortion self-referral is low, and it is ...Read more >