First-trimester medical abortion practices in Canada: National survey

Edith R. Guilbert; Althea S. Hayden; Heidi E. Jones; Katharine O’Connell White; E. Steven Lichtenberg; Maureen Paul; Wendy V. Norman

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Table 1.

Characteristics of Canadian facilities offering first-trimester MA services in 2012 who responded to the 2013 cross-sectional survey of abortion provision in the United States and Canada (administrator survey): N = 20.

CHARACTERISTICS	FACILITIES OFFERING MA, N (%)	ESTIMATED NO. OF FIRST-TRIMESTER MA IN 2012	ESTIMATED NO. OF FIRST-TRIMESTER MEDICAL AND SURGICAL ABORTIONS IN 2012	PROPORTION OF FIRST-TRIMESTER ABORTIONS THAT WERE MA IN 2012
Clinic size
• Small (< 500 abortions per y)	9 (45.0)	112	1044	10.7
• Medium (500–1000 abortions per y)	4 (20.0)	100	3251	3.1
• Large (> 1000 abortions per y)	7 (35.0)	2494	21 915	11.4
Region where site is located
• Atlantic Canada^*	0 (0.0)	NA	NA	NA
• British Columbia	7 (35.0)	2242	8090	27.7
• Ontario	2 (10.0)	101	2767	3.7
• Quebec	5 (25.0)	62	2821	2.2
• Prairies	4 (20.0)	274	12 099	2.3
• Territories	2 (10.0)	27	433	6.2
Facility type
• Private office or ambulatory health centre^†	11 (55.0)	2520	21 279	11.8
• Hospital affiliated	9 (45.0)	186	4931	3.8
Total	20 (100.0)	2706	26 210	10.3

MA—medical abortion, NA—not applicable.
↵* One MA provider survey was returned from the Atlantic region, but no MA was performed in 2012.
↵† Includes 2 facilities offering ambulatory MA services affiliated with a hospital-based surgical abortion service.

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Table 2.

Characteristics of Canadian physicians providing MAs in 2012 responding to the 2013 cross-sectional survey of abortion provision in the United States and Canada: N = 62.

CHARACTERISTICS	MA PROVIDERS, N (%)	ESTIMATED VOLUME OF MA^*
Age, y
• 30–39	16 (25.8)	Low
• 40–49	16 (25.8)	High
• 50–59	20 (32.3)	Moderate
• ≥ 60	9 (14.5)	High
• Unknown	1 (1.6)	NA
Sex
• Male	12 (19.4)	Low
• Female	49 (79.0)	High
• Unknown	1 (1.6)	NA
Specialty
• Obstetrics and gynecology	21 (33.9)	Moderate
• Family medicine	35 (56.5)	High
• Other	5 (8.1)	Moderate
• Unknown	1 (1.6)	NA
Region where physicians are located
• Atlantic Canada	1 (1.6)	Low
• British Columbia	9 (14.5)	High
• Ontario	7 (11.3)	Low
• Quebec	25 (40.3)	Low
• Prairies	11 (17.7)	Moderate
• Territories	9 (14.5)	Low
Provides surgical abortion
• Yes	54 (87.1)	High
• No	7 (11.3)	Low
• Unknown	1 (1.6)	Low
Total	62 (100.0)	NA

MA—medical abortion, NA—not applicable.
↵* The volume of MA reported by all physicians in a category is described as high (> 1000 MAs per y), moderate (150–1000 MAs per y), or low (< 150 MAs per y).

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Table 3.

Regimens for MA offered by Canadian physicians in 2012 who responded to the 2013 cross-sectional survey of abortion provision in the United States and Canada: N = 61; one physician did not respond to questions about MA regimens.

MA REGIMEN	PHYSICIANS USING METHOD, N (%)
Method of MA
• Misoprostol only	9 (14.8)
• IM methotrexate 50 mg/m² of body surface and misoprostol	42 (68.9)
• Methotrexate 50 mg orally and misoprostol	10 (16.3)
Initial dose of misoprostol
• 400 μg	4 (6.6)
• 800 μg	57 (93.4)
Misoprostol route
• Vaginal	47 (77.0)
• Sublingual	6 (9.8)
• Buccal	8 (13.1)
Misoprostol timing
• 1 or 2 d after methotrexate	12 (19.7)
• 3 d after methotrexate	11 (18.0)
• 4–6 d after methotrexate	18 (29.5)
• Other range (all ≤ 7 d)	10 (16.3)
• > 7 days after methotrexate	1 (1.6)
• Misoprostol only	9 (14.8)
Location misoprostol is taken
• At home	58 (95.1)
• At medical facility	3 (4.9)
Repeat dose of misoprostol
• Dispensed routinely	57 (93.4)
• Dispensed only as needed	3 (4.9)
• Never given	1 (1.6)
Total	61 (100.0)