Second-trimester abortion attitudes and practices among maternal-fetal medicine and family planning subspecialists

BMC Women's Health

A. B. Caughey¹  J. K. Turk²  J. L. Kerns²  J. E. Steinauer²  C. M. Corbetta-Rastelli²  M. G. Rosenstein² 

[1] Department of Obstetrics and Gynecology of Oregon Health & Science University;Department of Obstetrics, Gynecology and Reproductive Sciences, University of California;

关键词: Abortion;    Dilation and evacuation;    Family planning;    Induction termination;    Maternal fetal medicine;    Provider attitudes;   

DOI  :  10.1186/s12905-020-0889-9

来源: DOAJ

【 摘 要 】

Abstract Background Patients deciding to undergo dilation and evacuation (D&E) or induction abortion for fetal anomalies or complications may be greatly influenced by the counseling they receive. We sought to compare maternal-fetal medicine (MFM) and family planning (FP) physicians’ attitudes and practice patterns around second-trimester abortion for abnormal pregnancies. Methods We surveyed members of the Society for Maternal-Fetal Medicine and Family Planning subspecialists in 2010–2011 regarding provider recommendations between D&E or induction termination for various case scenarios. We assessed provider beliefs about patient preferences and method safety regarding D&E or induction for various indications. We compared responses by specialty using descriptive statistics and conducted unadjusted and adjusted analyses of factors associated with recommending a D&E. Results Seven hundred ninety-four (35%) physicians completed the survey (689 MFMs, 105 FPs). We found that FPs had 3.9 to 5.5 times higher odds of recommending D&E for all case scenarios (e.g. 80% of FPs and 41% of MFMs recommended D&E for trisomy 21). MFMs with exposure to family planning had greater odds of recommending D&E for all case scenarios (p < 0.01 for all). MFMs were less likely than FPs to believe that patients prefer D&E and less likely to feel that D&E was a safer method for different indications. Conclusion Recommendations for D&E or induction vary significantly depending on the type of physician providing the counseling. The decision to undergo D&E or induction is one of clinical equipoise, and physicians should provide unbiased counseling. Further work is needed to understand optimal approaches to shared decision making for this clinical decision.

【 授权许可】

Unknown