Provision of abortion and other reproductive health services among former Midwest Access Project trainees

Abstract

ObjectiveThe Midwest Access Project (MAP) offers opt-in training to students, residents and practicing clinicians in reproductive health care including abortion. We surveyed MAP alumni to identify current practice characteristics and assess predictors of reproductive health service provision. Study designWe sent an online survey to alumni of MAP's Individual Clinical Training program, 2007–2015 (n=127). The primary outcome was current provision of any abortion service. Secondary outcomes included providing specific abortion services and other reproductive services. ResultsWe received responses from 61% of eligible MAP alumni (n=77 out of 127). The majority reported a specialty of Family Medicine (68%) and current location in the Midwest (52%). Among current residents, fellows or clinicians practicing in a field whose scope includes abortion (n=56), 50% provide abortion. Most (84%) provide outpatient miscarriage management, and nearly all (≥96%) provide pregnancy options counseling and full scope contraception. Respondents who received the most advanced training in medication abortion as part of their MAP training were more likely to report providing abortion in their current practice than those who did not (63% vs. 32%, p=.027), as were those who completed more than one MAP rotation compared to those who completed one rotation (100% vs. 44%, p=.009). ConclusionsHalf of MAP's alumni provide some abortion care. Nearly all provide comprehensive counseling and contraceptive services. ImplicationsOpt-in training is a promising strategy to develop providers of comprehensive reproductive health care.