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Answering challenging abortion questions

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March 10 is Abortion Provider Appreciation Day.  Abortion providers often face misunderstandings about the work they do and the environment they work in. To show our appreciation for abortion providers we are addressing one such abortion myth. At a recent organizational retreat RHAP’s Medical Director, Linda Prine, MD, fielded the following challenging question:

“Do primary care clinicians have enough experience to perform abortions?  Don’t they have to do a lot of abortions to get it right?”

“While it is true that highly complex medical procedures, like open-heart surgery, are better performed by people who do it over and over many times a day, day after day; outcome level data has not been demonstrated for low complexity procedures, like uterine aspiration procedures or medication abortions. In fact, several studies have been published recently that show that outcomes for medication abortion in family medicine settings are as good, or better than the high volume practices led by OB/GYNs. Additionally, a study was done comparing outcomes of uterine aspiration procedures done by advanced practice clinicians in Vermont with OB/GYNs in New Hampshire, and both groups had the same very, very low complication rates.

What really matters for providing safe abortion care is having a good relationship with our patients, and having a system in place for after-hour questions or problems. In addition, getting abortions in a continuity practice, like a family health center, contributes to de-stigmatizing and normalizing the process. When a woman’s own primary care clinician provides her with her abortion she is less likely to feel shamed. And when that clinician also provides her follow up contraception she is more likely to come back to the same clinician when she has side effects or needs refills or has questions. In every other area of medicine, we have come to realize that continuity of care and clinician/patient relationships are the key to good medical care. Why would abortion care be any different?

In my practice, we offer many procedures that are also offered by specialists: mole removals, wart treatments, ingrown toenail removals, ear lobe repairs, IUD insertions, abortions, and so on. We do give our patients the option of having these procedures done elsewhere, by specialists. They almost always choose to stay with us, and often say, ‘I know and trust you. Why would I want to go somewhere else to see someone I don’t know?’”

On Abortion Provider Appreciation Day we honor all abortion providers as reproductive health heroes. The Reproductive Health Access Project is especially grateful to primary care abortion providers for the important work they do expanding access to abortion to underserved populations. We ♥  abortion providers!

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