First-trimester surgical abortion practice in Canada in 2012

[摘要] Objective To evaluate practices among first-trimester surgical abortionfacilities and providers in Canada in 2012 and examine the characteristics ofthe surgical abortion work force.Design Self-administered paper or electronic survey adapted from a surveypreviously fielded in the United States.Setting Canada.Participants Facility administrators and physicians.Main outcomes measures Descriptive statistics on reported first-trimestersurgical abortion practice and provider demographic characteristics.Results Eighty-three percent of identified facilities (78 of 94) and 178physicians responded. Of the respondents, 99% of facilities and 96% ofphysicians provided first-trimester surgical abortions. Responding facilitiesprovided 68,154 first-trimester surgical abortions in 2012. This represented96% of their reported total (combined medical and surgical) first-trimesterabortions. More than half (55%) of responding facilities were community based,while 45% were hospital affiliated. Most physician providers were female (68%)and were family doctors (59%). Preoperatively, 96% of physicians routinelyused ultrasound and 89% gave perioperative antibiotics. Almost half (48%)used manual vacuum aspiration, but less than 35% did so beyond 9 weeksafter the last menstrual period. At most facilities, most procedures wereperformed under combined local anesthesia and intravenous sedation (73%);only 7% indicated deep sedation or general anesthesia were used exclusively.Postoperatively, 81% of physicians performed immediate tissue examinationand 96% offered postabortion contraception on the same day as the abortion.Other assessed outcomes included medication regimens and cervicalpreparation, with a high degree of consistency among facilities and physicians.Conclusion First-trimester surgical abortion providers are mostly familyphysicians and most are female. Practices across Canada were mostly uniformand followed evidence-based guidelines. Uptake of the most recent Canadianpractice guidelines may help further standardize patient care and improveroutine perioperative antibiotic use and immediate tissue examination.

[学科分类] 卫生学