Category and key concerns | Supporting participant quotes from posts |
1. Clinical knowledge
| “I am looking for some latest evidence behind giving Anti D [after EMA] for Rh neg blood group, there seems to be mixed medical opinions.” [Nurse, provides EMA] “Any tips for inserting IUDs in nulliparous young women? Last fortnight I had two consecutive young women in whom I was unable to insert a [hormonal] IUD due to not being able to get the sound through a tight cervix. … is [there] anything else I could try?” [GP, inserts IUDs] |
2. Training and upskilling
| “Has anyone done a GP early pregnancy ultrasound course? My clinic has an ultrasound machine so I'd love to do a course to provide dating/location scan for EMA provision.” [GP, does not provide EMA] “I am looking for guidance about how many IUDs a GP is required to insert per year to maintain competence? … I work only part time and feel that losing my competency is likely as I may only do a handful per year.” [GP, does not insert IUDs] |
3. Tools for practice
| “I cannot find the … guidelines for RPOC [retained products of conception], can you point me in the right direction?” [GP, does not provide EMA] “Hi all, I wondered whether or not any of you have any experience in using any handy tools to help retrieve strings that are curled up within the cervical canal in a GP setting? I have tried the [endocervical sampling brush] but find I only have occasional success with it!” [GP, inserts IUDs] |
4. Service implementation
| “I am a nurse that provides [EMA] counselling. A consult can be anywhere from 10 min to ~30 min … This is all before they see the GP! I discuss consult costs and routine follow-up … and send reminders.” [Nurse, provides EMA] “I am wondering what most people do when following up a patient post-IUD insertion. Do you do a string check after 4–6 weeks or a formal ultrasound by Radiology to check IUD placement?” [GP, inserts IUDs] |
5. Ethical issues
| “I remind myself it isn’t my place to judge whether they have one abortion or ten, and whether they will accept contraception or not … we need to concentrate on providing safe medical service not MORAL services.” [GP, provides EMA] “We began screening for both intimate partner violence [IPV] and reproductive coercion [RC] … we can offer hidden options for contraception if that’s wanted…” [Nurse, inserts contraceptive implants and IUDs] |
6. Health system and regulatory issues
| “Can I ask if the pharmacy then just charges the PBS [Pharmaceutical Benefits Scheme] price for dispensing [EMA] or are there any other charges for the patient? I assume that only approved prescribers can obtain an authority script and you wouldn't ever see it prescribed privately, is that right? [Pharmacist, does not dispense EMA] “For those interested, the ACT [Australian Capital Territory] Legislative Assembly have published their findings and recommendations for the inquiry into abortion and reproductive choice…” [GP, provides EMA] |
EMA, early medical abortion; GP, general practitioner; IUD, intrauterine device; LARC, long-acting reversible contraception.