TY - JOUR
T1 - Barriers to and Enablers of Abortion Provision for Family Physicians Trained in Abortion During Residency
AU - Summit, Aleza K.
AU - Lague, Ian
AU - Dettmann, Miranda
AU - Gold, Marji
N1 - Publisher Copyright:
Copyright © 2020 by the Guttmacher Institute
PY - 2020/9
Y1 - 2020/9
N2 - CONTEXT: Although some family medicine residency programs include routine opt-out training in early abortion, little is known about abortion provision by trainees after residency graduation. A better understanding of the barriers to and enablers of abortion provision by trained family physicians could improve residency training and shape other interventions to increase abortion provision and access. METHODS: Twenty-eight U.S. family physicians who had received abortion training during residency were interviewed in 2017, between two and seven years after residency graduation. The doctors, identified using databases of abortion-trained physicians maintained by residency programs, were recruited by e-mail. In phone interviews, they described their postresidency abortion provision experiences. All interviews were transcribed, coded and analyzed using Dedoose, and a social-ecological framework was employed to guide investigation and analysis. RESULTS: Although many of the physicians were motivated to provide abortion care, only a minority did so. Barriers to and enablers of abortion provision were found on all levels of the social-ecological model—legal, institutional, social and individual—and included state-specific laws and restrictions on federal funding; religious affiliation or policies prohibiting abortion within particular health systems; mentorship, colleagues’ support and the stigma of being an abortion provider; and geographic location, time management and individuals’ prioritization of abortion provision. CONCLUSIONS: Clinical training alone may not be sufficient for family medicine physicians to overcome the barriers to postresidency abortion provision. To increase abortion provision and access, organizations and advocates should work to strengthen enablers of provision, such as strong mentorship and support networks.
AB - CONTEXT: Although some family medicine residency programs include routine opt-out training in early abortion, little is known about abortion provision by trainees after residency graduation. A better understanding of the barriers to and enablers of abortion provision by trained family physicians could improve residency training and shape other interventions to increase abortion provision and access. METHODS: Twenty-eight U.S. family physicians who had received abortion training during residency were interviewed in 2017, between two and seven years after residency graduation. The doctors, identified using databases of abortion-trained physicians maintained by residency programs, were recruited by e-mail. In phone interviews, they described their postresidency abortion provision experiences. All interviews were transcribed, coded and analyzed using Dedoose, and a social-ecological framework was employed to guide investigation and analysis. RESULTS: Although many of the physicians were motivated to provide abortion care, only a minority did so. Barriers to and enablers of abortion provision were found on all levels of the social-ecological model—legal, institutional, social and individual—and included state-specific laws and restrictions on federal funding; religious affiliation or policies prohibiting abortion within particular health systems; mentorship, colleagues’ support and the stigma of being an abortion provider; and geographic location, time management and individuals’ prioritization of abortion provision. CONCLUSIONS: Clinical training alone may not be sufficient for family medicine physicians to overcome the barriers to postresidency abortion provision. To increase abortion provision and access, organizations and advocates should work to strengthen enablers of provision, such as strong mentorship and support networks.
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U2 - 10.1363/psrh.12154
DO - 10.1363/psrh.12154
M3 - Article
C2 - 33051986
AN - SCOPUS:85092538508
SN - 1538-6341
VL - 52
SP - 151
EP - 159
JO - Perspectives on Sexual and Reproductive Health
JF - Perspectives on Sexual and Reproductive Health
IS - 3
ER -