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Abstract
Objectives The primary objective of this study was to assess the feasibility of initiating medical abortions in a large, academic emergency department (ED) in the United States.
Methods A retrospective case series analysis was conducted to evaluate a protocol for initiating medical abortion in the ED implemented from January 2020 to October 2023 at an academic, tertiary care hospital in California, USA. Participants included ED patients diagnosed with pregnancies in the first trimester that were undesired and who opted for medical abortion. The medical abortion protocol was collaboratively designed by a multidisciplinary team and follow-up was conducted by our institution’s gynaecology department. Data were sourced from a data repository of electronic health records and subjected to descriptive statistical analysis.
Results A total of 27 eligible patients initiated medical abortions in the ED during the study period. The cohort was diverse in terms of racial and ethnic backgrounds and almost evenly split between private and public insurance. No patients had significant complications identified in the medical record. Two patients required uterine aspiration by the gynaecology team; one patient in clinic and one during a return visit to the ED.
Conclusions Data from this case series suggest that initiating medical abortion in the ED is feasible. The ED may be considered as an additional access point for abortion care services, especially in areas where other care options are not readily available. Educational, legal and regulatory frameworks that allow emergency physicians to take a greater role in providing this care should be considered.
- abortion, induced
- family planning services
- Reproductive Health Services
Data availability statement
Data are available upon reasonable request. Data are available upon reasonable request to the corresponding author.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request. Data are available upon reasonable request to the corresponding author.
Footnotes
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Contributors CP, MS, and AH conceived of the study and designed the study protocol. CP performed data collection, which was verified by MS and AH. CP completed data analysis. All authors participated in the drafting of the manuscript, contributed substantially to its revision, approved the final version of the manuscript, and agree to be accountable for their contributed work. CP takes responsibility for the paper as a whole.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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