Prine, L and Lesnewski, R.
The Journal of the American Board of Family Practice July 2005; Volume 18, Number 4, 304-30
Since the founding of family medicine, family physicians have repeatedly defended its scope of practice. The right to provide maternity care, colonoscopy, and surgical procedures has been disputed and defended in many forums. Medication abortion, an office-based service that many family physicians would like to offer to women with unintended pregnancies, is a new addition to this list of contested procedures. Nearly half of all pregnancies in the United States are unintended; of these, approximately half end in abortion. Approximately 35% of American women have an abortion at some point in their lives. But many women have difficulty accessing abortion care; 87% of all counties in the United States have no abortion provider. When the FDA approved mifepristone in 2000, many observers believed that pro-choice primary care physicians would expand abortion care to underserved communities in the United States. Unfortunately, restrictions in professional liability coverage and insurance reimbursement have hindered this progress. Many family physicians have found that their professional liability insurance does not cover medication abortion.