Abortion in Primary Care

"They Go Hand in Hand": Perspectives on the Relationship Between the Core Values of Family Medicine and Abortion Provision Among Family Physicians Who Do Not Oppose Abortion.

Wulf S, Carvajal DN, Razon N, Perez C, McNeil S, Maldonado L, Fields AB, Silverstein I, Dehlendorf C.J Am Board Fam Med. 2023 Aug 9;36(4):583-590. doi: 10.3122/jabfm.2022.220301R2. Epub 2023 Jun 15.PMID: 37321654 Free article.

This study seeks to understand how family physicians themselves perceive the relationship between their specialty's values and abortion provision. METHODS: We conducted in-depth interviews in 2019 with 56 family physicians who do not oppose abortion in the Un …

Consent for trainee participation in abortion care: A qualitative study of patient experiences and preferences in the United States.

Crystal-Ornelas L, Sarnaik S, Dianat S, Dehlendorf C, Holt K.Contraception. 2023 May;121:109974. doi: 10.1016/j.contraception.2023.109974. Epub 2023 Feb 8.PMID: 36758737 Free article.

OBJECTIVES: Abortion training for clinicians is crucial to ensure patients' future access to full-spectrum reproductive healthcare. Given the complex sociopolitical context of abortion, consent to allow a trainee's involvement in abortion care requires …

Borrero S, Talabi MB, Dehlendorf C.JAMA. 2022 Nov 1;328(17):1701-1702. doi: 10.1001/jama.2022.18328.PMID: 36318124

This Viewpoint discusses the exclusion of abortion care from many established medical sources (such as hospitals) and from coverage by many major payers and how the health care system should legitimize and ensure clinician training in safe abortion care....

Razon N, Wulf S, Perez C, McNeil S, Maldonado L, Fields AB, Holt K, Fox E, Silverstein I, Dehlendorf C.J Am Board Fam Med. 2022 May-Jun;35(3):579-587. doi: 10.3122/jabfm.2022.03.210266.PMID: 35641055 Free article.

PURPOSE: Medication abortion (MAB) provision by family physicians has the potential to expand abortion access. ...We categorized participants into 3 groups: (1) doctors who did not receive training and do not provide abortions (n = 11), (2) doctors who receiv …

Razon N, Wulf S, Perez C, McNeil S, Maldonado L, Fields AB, Carvajal D, Logan R, Dehlendorf C.Contraception. 2022 May;109:19-24. doi: 10.1016/j.contraception.2022.01.017. Epub 2022 Feb 4.PMID: 35131289 Free PMC article.

The FDA's revised REMS criteria may ease administrative burden but will likely maintain key barriers to integrating medication abortion into family physicians' practice. IMPLICATIONS: Our study highlights that the REMS criteria are barriers to family physicians' abi …

Lerma K, McBrayer A, Nathan S, Dehlendorf C, White K.Contraception. 2022 Sep;113:68-70. doi: 10.1016/j.contraception.2022.01.011. Epub 2022 Jan 23.PMID: 35081390

OBJECTIVE: To evaluate the use of a contraceptive decision support tool in the abortion care setting. STUDY DESIGN: In 2019, Mississippi residents aged 18 to 45 used a tablet-based decision support tool at the consultation visit and completed a survey about their satisfact …

Karlin J, Sarnaik S, Holt K, Dehlendorf C, Joffe C, Steinauer J.Contraception. 2021 Sep;104(3):289-295. doi: 10.1016/j.contraception.2021.04.022. Epub 2021 Apr 28.PMID: 33932400 Free PMC article.

RESULTS: Survey results revealed that clinics substantially changed their medication abortion protocols in response to COVID-19, with more than half increasing their gestational age limits and introducing telemedicine for follow-up of a medication abortion. ...IMPLI …

Dianat S, Silverstein IA, Holt K, Steinauer J, Dehlendorf C.Contracept X. 2020 Jun 16;2:100029. doi: 10.1016/j.conx.2020.100029. eCollection 2020.PMID: 32671336 Free PMC article.

For some patients, mentioning abortion may reduce abortion stigma and help contraceptive decision-making. ...For some patients, mentioning abortion may reduce abortion stigma and help contraceptive decision-making....

Donnelly KZ, Dehlendorf C, Reed R, Agusti D, Thompson R.J Patient Rep Outcomes. 2019 Jan 21;3(1):3. doi: 10.1186/s41687-018-0089-7.PMID: 30666466 Free PMC article.

BACKGROUND: Women value receiving quality interpersonal care during abortion services, yet no measure exists to assess this outcome from patients' perspectives. ...Adults who spoke English and/or Spanish, had an abortion in the past year, and lived in the US were el …

Borrero S, Frietsche S, Dehlendorf C.J Gen Intern Med. 2019 Jan;34(1):144-145. doi: 10.1007/s11606-018-4703-4. Epub 2018 Oct 18.PMID: 30338473 Free PMC article. Review. No abstract available.

Moseson H, Gerdts C, Dehlendorf C, Hiatt RA, Vittinghoff E.Popul Health Metr. 2017 Dec 21;15(1):40. doi: 10.1186/s12963-017-0157-x.PMID: 29268794 Free PMC article. Clinical Trial.

With a recently developed statistical test that can detect the presence of a design effect - the absence of which is a central assumption of the list experiment method - we sought to test the validity of a list experiment conducted on self-reported abortion in Liberia. We …

Block A, Dehlendorf C, Biggs MA, McNeil S, Goodman S.Fam Med. 2017 Oct;49(9):706-713.PMID: 29045988 Free article.

BACKGROUND AND OBJECTIVES: Family physicians are critical to reproductive health service provision including miscarriage management and abortion care, but many graduates report barriers in integrating these services into practice. ...RESULTS: Forty-two percent of CREATE gr …

Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

Holt K, Janiak E, McCormick MC, Lieberman E, Dehlendorf C, Kajeepeta S, Caglia JM, Langer A.Fam Med. 2017 Jul;49(7):527-536.PMID: 28724150 Free article.

Seventy-one percent believed residency training in options counseling should be required, and 69% believed PCPs have an obligation to provide abortion referrals even in the presence of a personal objection to abortion. However, only 26% reported routine options coun …

"Every Person's Just Different": Women's Experiences with Counseling for Early Pregnancy Loss Management.

Wallace R, DiLaura A, Dehlendorf C.Womens Health Issues. 2017 Jul-Aug;27(4):456-462. doi: 10.1016/j.whi.2017.02.008. Epub 2017 Mar 31.PMID: 28372936

Women are often weighing personal priorities to make decisions about EPL management and use of a decision aid may offer a systematic approach to identifying women's preferences for treatment....

Jackson AV, Karasek D, Dehlendorf C, Foster DG.Contraception. 2016 May;93(5):406-11. doi: 10.1016/j.contraception.2015.12.010. Epub 2015 Dec 29.PMID: 26738619

OBJECTIVES: To understand women's preferences for specific features of contraceptive methods, the extent to which features of existing methods match women's preferences and whether this match differs by racial and ethnic subgroups. STUDY DESIGN: Using data from 1783 …

Moseson H, Massaquoi M, Dehlendorf C, Bawo L, Dahn B, Zolia Y, Vittinghoff E, Hiatt RA, Gerdts C.Int J Epidemiol. 2015 Dec;44(6):1951-8. doi: 10.1093/ije/dyv174.PMID: 26342584 Free PMC article. Clinical Trial.

BACKGROUND: Direct measurement of sensitive health events is often limited by high levels of under-reporting due to stigma and concerns about privacy. Abortion in particular is notoriously difficult to measure. This study implements a novel method to estimate the cumulativ …

Dehlendorf CE, Fox EE, Ali RF, Anderson NC, Reed RD, Lichtenberg ES.Contraception. 2015 Nov;92(5):463-8. doi: 10.1016/j.contraception.2015.07.011. Epub 2015 Jul 29.PMID: 26226101

OBJECTIVE: To investigate the association between previous cesarean delivery and medication abortion failure and the association between parity and failure. METHODS: Data were abstracted from 2035 consecutive charts of women who underwent medication abortion in 2011 …

Steinauer JE, Sokoloff A, Roberts EM, Drey EA, Dehlendorf CE, Prager SW.Contraception. 2014 Jan;89(1):42-7. doi: 10.1016/j.contraception.2013.03.002. Epub 2013 Mar 13.PMID: 24176251 Clinical Trial.

BACKGROUND: Immediate start of the contraceptive patch has not been studied in women after surgical abortion. STUDY DESIGN: Women presenting for surgical abortion who had chosen the transdermal patch for contraception were randomized to either delayed start of the p …

Disparities in abortion rates: a public health approach.

Dehlendorf C, Harris LH, Weitz TA.Am J Public Health. 2013 Oct;103(10):1772-9. doi: 10.2105/AJPH.2013.301339. Epub 2013 Aug 15.PMID: 23948010 Free PMC article.

Opponents of abortion use these statistics to argue that abortion providers are exploiting women of color and low socioeconomic status, and thus, regulations are needed to protect women. This argument ignores the underlying causes of the disparities. As efforts to r …

Pregnancy options counseling for adolescents: overcoming barriers to care and preserving preference.

Dobkin LM, Perrucci AC, Dehlendorf C.Curr Probl Pediatr Adolesc Health Care. 2013 Apr;43(4):96-102. doi: 10.1016/j.cppeds.2013.02.001.PMID: 23522340

Recent research suggests that relative to adult women, adolescents are at increased risk of being denied abortion because they present beyond facilities' gestational age limits. Counseling that neglects to address the structural and developmental challenges that adolescent …

Goodman S, Shih G, Hawkins M, Feierabend S, Lossy P, Waxman NJ, Gold M, Dehlendorf C.Fam Med. 2013 Mar;45(3):180-6.PMID: 23463431 Free article.

Previous studies have evaluated the immediate impact of training family physicians in abortion and reproductive health care but have not conducted long-term follow-up of those trained. ...Of those residents intending future abortion provision, 40% went on to do so. …

Wallace R, Dehlendorf C, Vittinghoff E, Gold KJ, Dalton VK.Fam Med. 2013 Mar;45(3):173-9.PMID: 23463430 Free article.

METHODS: We performed a secondary analysis of a national survey of women's health providers to describe demographic and practice characteristics among family physicians who care for women with EPF. ...Women's questions after postabortion insertion of intrauterine contraception.

Diedrich JT, Drey EA, Dehlendorf C, Steinauer JE.Contraception. 2013 Sep;88(3):396-400. doi: 10.1016/j.contraception.2012.11.012. Epub 2012 Dec 21.PMID: 23265979

The goal of this investigation was to document women's questions and to assess retention of information provided during contraceptive counseling after immediate postabortion intrauterine contraceptive placement. ...CONCLUSION: Although IUCs are highly effective and their p …

Steinauer J, Dehlendorf C, Grumbach K, Landy U, Darney P.Contraception. 2012 Sep;86(3):188-90. doi: 10.1016/j.contraception.2011.12.001. Epub 2012 Apr 23.PMID: 22534076 No abstract available.

Dehlendorf C, Weitz T.J Health Care Poor Underserved. 2011 May;22(2):415-21. doi: 10.1353/hpu.2011.0064.PMID: 21551921

Minority and low SES women have persistently and disproportionately higher rates of abortion than White and higher SES women, yet have limited access to these services. The response of governmental health agencies to these disparities in abortion has focused solely …

Dehlendorf C, Diedrich J, Drey E, Postone A, Steinauer J.Patient Educ Couns. 2010 Dec;81(3):343-8. doi: 10.1016/j.pec.2010.06.021. Epub 2010 Jul 21.PMID: 20650593 Free PMC article.

This study compared decision-making preferences for contraception to preferences for general health among reproductive-aged women. METHODS: 257 women receiving abortion care in an urban hospital completed a survey which included questions adapted from the Problem-Solving D …

Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J.Am J Obstet Gynecol. 2010 Mar;202(3):214-20. doi: 10.1016/j.ajog.2009.08.022.PMID: 20207237 Free PMC article. Review.

Prominent racial/ethnic and socioeconomic disparities in rates of unintended pregnancy, abortion, and unintended births exist in the United States. These disparities can contribute to the cycle of disadvantage experienced by specific demographic groups when women are unabl …

Dehlendorf CE, Grumbach K.Am J Public Health. 2008 Oct;98(10):1770-4. doi: 10.2105/AJPH.2008.136325. Epub 2008 Aug 13.PMID: 18703433 Free PMC article. Review.

Family physicians who wish to provide abortions have been subject to both denial of coverage by medical liability insurers and the imposition of large premium increases. ...We review the issues specific to abortion services in the primary care setting and examine th …

Brahmi D, Dehlendorf C, Engel D, Grumbach K, Joffe C, Gold M.Fam Med. 2007 Jun;39(6):399-403.PMID: 17549648

BACKGROUND AND OBJECTIVES: Access to abortion services in the United States is declining. While family physicians are well suited to provide this care, limited training in abortion occurs in family medicine residency programs. ...In addition, residents valued discus …

Dehlendorf C, Brahmi D, Engel D, Grumbach K, Joffe C, Gold M.Fam Med. 2007 May;39(5):337-42.PMID: 17476607 Free article.

BACKGROUND AND OBJECTIVES: Family physicians provide many office-based procedures in primary care settings. While first-trimester abortion is a procedure appropriate for and performed by family physicians, few residency programs offer routine training in this skill. This s …