ABSTRACT
OBJECTIVE: Communication of information is a key component of quality family planning services. It allows for an informed choice between surgical and medication abortion. METHODS: Québec abortion clinics were contacted by 2 mystery client clinical profiles (PC) between October 8 and November 17, 2021. Data collection was done simultaneously by a data collector. The unit of analysis was the PC. Descriptive analyses and statistical tests were performed, as well as a qualitative analysis of the collected comments. RESULTS: Of the 17 information topics deemed necessary for an informed choice, 35% were obtained spontaneously. These included what tests to perform (78%), professionals to meet before the procedure (77%), gestational age limit (64%), side effects (49%) (especially alarming ones), and the number of visits required (42%). On a score of 12, the average information quality score was 7.2 (standard deviation [SD] 2.7). A score of less than 7/12 was obtained by 41% of PCs. A high information quality score was associated with a perceived friendlier attitude of the person responding to the call, and the unprompted transmission of more information. For 51/78 PCs, abortifacient medications were served at the clinic, and for 13 of them, the first medication had to be taken in front of the physician. CONCLUSION: The information received when calling Québec abortion clinics for an appointment for abortion was often insufficient and made it difficult to make an informed choice between the 2 methods of abortion. This may explain the low proportion of medication abortion in Québec.
Subject(s)
Communication , Pregnancy , Female , Humans , QuebecABSTRACT
OBJECTIVE: In 2020, 11.9% of abortions in Quebec were medication abortions, compared with 32.4% in Ontario. The objective of this evaluation was to assess the quality of access to medication abortion in Quebec abortion clinics, where 91% of these abortions are performed. METHODS: Quebec abortion clinics were contacted by 2 mystery client clinical profiles between October 8 and November 17, 2021. Descriptive analyses and statistical tests were performed, as well as a qualitative analysis of collected comments. RESULTS: Medication abortion up to 63 days of gestational age or less was available in 39/47 abortion clinics, more in rural and remote areas than in urban or suburban areas (P = 0.013). The mean time from first call to first appointment was 6.2 calendar days (standard deviation [SD] 4.0), shorter in rural and remote areas (P = 0.005) and in clinics affiliated with a hospital or local community service center (P = 0.010). The mean number of visits required for medication abortion was higher than for surgical abortion (2.9 [SD] 0.9 vs. 2.3 [SD] 1.1) (P < 0.001). For one in three clinical profiles (26/78, 33%), a telemedicine visit was possible. Medication abortion entirely accessible through telemedicine was not available. Unfavorable comments about medication abortion were frequent. CONCLUSION: Access to medication abortion is difficult in Quebec and access through telemedicine is almost non existent. Restrictions imposed by the Collège des médecins du Québec (CMQ) and constraints imposed on patients limit access.
