What skills do New Zealand clinicians have to provide first trimester abortion in primary care and are they willing?

Abstract

ObjectiveTo determine the skills and intentions of health practitioners in New Zealand to provide first trimester abortion care.New Zealand achieved abortion law reform in 2020, changing how abortion could be delivered and experienced by pregnant people. However, little has changed in the way abortion care is provided.Study design: This survey, which was deployed to a range of health practitioners via regulatory bodies and professional groups, used an online free text and tick box survey. Questions included demographics, scope of practice, abortion care experience, philosophical perspective on abortion, and skills transferable to abortion care. Data was analysed using descriptive statistics and deductive and inductive thematic analysis. Results128 respondents included doctors, nurses, midwives, counsellors, and social workers from a range of practice settings, the majority from primary health (51%). Most respondents indicated competency or proficiency in clinical skills relevant to provision of early medical abortion. However, practitioners were more likely to indicate “I do not have this skill” or “support required” for: calculating gestational age by bimanual examination (42%), LARC (implant and IUC) insertion (36%), undertake a pregnancy related consultation using tikanga best practice guidelines (19%).Analysis of qualitative data showed three main themes; (1) support for abortion access and for abortion provision in primary care (2) levels of intention to provide abortion (3) critical components for an action plan for abortion in primary care. ConclusionAbortion care in the community has support from health practitioners. They identified needs including development of clinical skills, funding, and wider sector support.