Transcript Slide 1

Mid-Level Providers of
Medical Abortion
in the
United States
Elizabeth Talmont, MSN, NP
Regimen
Up to 63 days LMP
Day 1
• Ultrasound required
• 200 mg mifepristone at clinic
• Antibiotics X 7 days
Day 2 or 3
• 800 mcg buccal misoprostol, self-administered
Day 7-14
• Return to clinic for ultrasound
Total Number of Medical vs. In-Clinic Abortions, 2002-2008
250000
Total SAB, 227032
Total Number of Abortions
200000
150000
Total MAB, 96976
100000
50000
0
2002
2003
2004
2005
2006
2007
2008
Growth of Planned Parenthood Health Centers Offering MAB Only
Source: CAPS Mifepristone Quarterly Surveyy and Data Analytics Group Medical
Center Directory
Total Number of APCs vs. Medical Doctors, 2002-2007
1800
1600
1400
Total Number Providers
1200
1000
800
600
400
200
0
Total APCs
2002
1564.95
2003
1579.15
2004
1562.18
2005
1588.1
2006
1637.7
2007
1634.2
Total MDs
495
589
606
627.25
550
550
Abortion Care Team
• Health Educator (non-licensed)
– Patient Education, laboratory and in some cases ultrasound.
• Mid-levels
– Ultrasound, physical exam, lab
– Prescribe and give out abortion medications
– ½ of all medical abortion clinics do not have surgical back up on
site.
• Physicians – as needed.
• Mid-level providers want and can provide medical
abortion
• Key outcomes:
–
–
–
–
Safe
Cost effective
Increased early access to abortion
Patients are satisfied when we give them what they want,
when they want it!
“Abortion is almost as
old as childbirth.
There has always
been a need for some
women to end their
pregnancies. In
modern times, the
law’s attitude toward
it has varied.”
Jeffery Toobin, The New Yorker
(11/23/09)
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