ABORTION CARE IN THE EMERGENCY DEPARTMENT: A NATIONAL SURVEY OF EMERGENCY MEDICINE PHYSICIANS’ PERSPECTIVES

Abstract

Objectives

The emergency department is a common setting of unintended pregnancy diagnoses, particularly for patients with limited access to healthcare. Reproductive health services can be provided in the emergency setting to expand care for this population, especially important post Dobbs v Jackson Women’s Health Organization. This study seeks to assess emergency medicine physicians’ current knowledge, attitudes, and practices, before and after Dobbs, related to pregnancy options counseling, referrals, and provision of induced abortion in the emergency department.

Methods

We surveyed a sample of emergency medicine physicians at a national meeting regarding knowledge, attitudes, and practices related to reproductive healthcare delivery. Kruskall-Wallis tests were used to evaluate differences between abortion restrictive and permissive states and chi-squared tests were used to compare proportions between the two groups. Thematic analysis was used to review qualitative responses.

Results

A total of 252 emergency medicine physicians completed the survey, 218 (86.5%) from abortion permissive and 30 (11.9%) from abortion restrictive states. Most (n=178, 70.6%) supported abortion provision in the emergency department if legally allowed although only about half (n=131, 52.0%) report ever prescribing medication abortion pills. Only 27 (10.7%) report possessing enough knowledge or having received adequate training to independently prescribe medication abortion.

Conclusions

Abortion can and should be provided in the emergency department, especially in an attempt to expand access to reproductive healthcare after the Dobbs decision. While most emergency medicine physicians support the provision of abortion care this setting, they do not routinely provide it due to a variety of factors including lack of knowledge, lack of training, and legal/institutional restrictions.