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Abortion provision in primary care: A qualitative study of post-training barriers and facilitators in underserved areas of New England

Charlotte Lee, BA, Brown University

Importance: Access to safe abortion has declined in New England states such as Maine and New Hampshire, where there has been a 20% decrease in the number of abortion clinics between 2011 and 2014. This is a core public health issue that affects racial and ethnic minorities and low SES women disproportionately. Primary care physicians (PCPs) and advanced practice clinicians (APCs) have unique potential to improve abortion access in the region because primary care settings are geographically easier for many patients to access compared to specialty providers and hold high potential for sustainability when abortion care is co-located with other clinical services.

Objective: Describe structural and interpersonal barriers to and facilitators of abortion provision among trained PCPs and APCs in underserved areas of New England.

Design, setting, and participants: A semi-structured interview guide will be used to conduct phone interviews, exploring PCPs' and APCs' experiences with, barriers to, and facilitators of incorporation of abortion care into primary care practice. We will recruit a purposive sample of up to 40 providers from two groups: A) PCPs and APCs who do not currently regularly provide abortion, but who are prepared to provide based on prior training, current practice scope, and expressed interest in providing abortion and B) PCPs and APCs who currently provide abortion in an integrated primary care or multispecialty setting. PCPs will include family medicine physicians and internal medicine physicians and APCs will include NPs, CNMs, and PAs. The recruitment region includes Maine, Vermont, New Hampshire, Massachusetts, and Rhode Island.


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