Obstetrician-gynecologist willingness to provide medication abortion with removal of the in-person dispensing requirement for mifepristone

Abstract

ObjectiveTo estimate obstetrician-gynecologists’ (ob-gyns) willingness to provide medication abortion if the in-person dispensing requirement for mifepristone were removed. Study designWe analyzed a subsample (n = 868) from a 2016 to 2017 national survey of ob-gyns, focusing on questions related to provision of medication abortion. ResultsIn the survey, 164 (19%) ob-gyns reported providing medication abortion in the prior year. When we asked those not providing medication abortion if they would offer the method to their patients if the in-person dispensing requirement for mifepristone were removed, 171 (24%) ob-gyns reported they would, suggesting a potential doubling of providers (+104%, 95% confidence interval (CI): 97%−112%). The largest theoretical increases were in the Midwest (+189%, 95% CI: 172%−207%) and South (+118%, 95% CI: 103%−134%). In multivariable regression analysis, female ob-gyns and those in university faculty practices had higher odds of reporting they would start providing medication abortion if the dispensing requirement were removed, while those in practice >10 years had lower odds. ConclusionsRemoval of the in-person dispensing requirement could increase provision of medication abortion, including in regions with limited abortion access. ImplicationsIn order to improve access to medication abortion, the mifepristone Risk Evaluation and Mitigation Strategy should be modified or removed to allow clinicians to prescribe the medication with dispensing by pharmacies, including mail-order pharmacies.