Attitudes and intentions of future health care providers toward abortion provision.Women have long used various techniques to terminate unwanted pregnancies--whether abortion has been accessible, safe or legal. (1) Currently, more than one-fifth of all pregnancies (2) and half of unintended pregnancies in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. end in abortion. (3) Surgical abortion remains one of the most common surgical procedures Surgical procedures have long and possibly daunting names. The meaning of many surgical procedure names can often be understood if the name is broken into parts. For example in splenectomy, "ectomy" is a suffix meaning the removal of a part of the body. "Splene-" means spleen. for women of reproductive age; (4) however, 87% of all U.S. counties did not have an abortion provider a`bor´tion pro`vid´er n. 1. same as abortionist. in 2000. (5) Meanwhile, the number of abortion providers has been declining, and more than half of providers who have ever performed an abortion are at least 50 years old. (6) Requirements that prohibit advanced clinical practitioners (i.e., physician assistants, nurse practitioners nurse practitioner n. Abbr. NP A registered nurse with special training for providing primary health care, including many tasks customarily performed by a physician. and nurse-midwives) from providing abortion services exacerbate the provider shortage. (7) Despite evidence that trained advanced clinical practitioners are able to conduct safe abortions, 44 states have laws prohibiting them from doing so. (8) However, health care providers have not extensively studied these restrictions. Furthermore, limited research has explored whether advanced clinical practitioners would be interested in providing these services, particularly since the Food and Drug Administration's September 2000 approval of the use of mifepristone Mifepristone Definition Mifepristone is a pill that can be taken as an alternative to a surgical abortion. Purpose This medication most often is used for ending early pregnancies. and misoprostol for medical abortions medical abortion Obstetrics An elective nonoperative abortion effected in the 1st trimester by abortifacients. See Abortion. . The study on which this article is based examined the abortion-related attitudes of future health care providers attending the University of Washington and their intention to provide abortion services in their practices. The primary outcome of this study was students' intention to incorporate abortion into their practice. Secondary outcomes were willingness to seek abortion training and attitudes toward advanced clinical practitioner provision of abortion services. On the basis of previous work, we hypothesized that students in medical programs, those in women's health-oriented programs and those who spent their first 15 years of life in an urban area would be more likely than others to intend to provide abortions, once age, sex and religion are controlled for. Also, we predicted that students would be more willing to perform medical abortions than surgical abortions, because medical abortions are limited to first-trimester terminations of pregnancy. METHODS Sample Selection Students enrolled in the University of Washington School of Medicine The University of Washington School of Medicine (UWSOM) is a public medical school located in Seattle, Washington. It is a graduate school affiliated with the University of Washington, and is the only medical school in the states of Washington, Wyoming, Alaska, and Idaho. , physician assistant program (MEDEX MEDEX Medical Express MEDEX Medical Excellence ) or School of Nursing were eligible to participate. We selected our sample on the basis of student availability within each program. First-and second-year nursing and MEDEX students were offered the survey, as were second-year medical students; first-year medical students were not eligible to participate because they were geographically dispersed dis·perse v. dis·persed, dis·pers·ing, dis·pers·es v.tr. 1. a. To drive off or scatter in different directions: The police dispersed the crowd. b. in five northwestern states, * and it would have been too challenging to survey them without breaching confidentiality. The study was reviewed and approved by the university's institutional review board. Questionnaire and Data Collection Results of previous research exploring attitudes toward abortion informed the creation of our survey. (9) The survey was developed by the study team and reviewed by several University of Washington faculty members, including representatives from the advanced clinical practitioner community. Ten allied health students who were not in their first or second year at the University of Washington pilot-tested the survey, and then we further refined it. The 22-item self-report survey consisted of four parts: demographic information; attitudes toward abortion, abortion training and advanced clinical practitioner provision of abortion services; intention to provide abortion; and willingness to seek abortion training. Using a five-point Likert scale Likert scale A subjective scoring system that allows a person being surveyed to quantify likes and preferences on a 5-point scale, with 1 being the least important, relevant, interesting, most ho-hum, or other, and 5 being most excellent, yeehah important, etc , respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. were asked to specify their strength of agreement with eight statements regarding the availability and accessibility of abortion; response options ranged from "strongly disagree" to "strongly agree." They were also asked to indicate on a five-point scale of "definitely yes" to "definitely no" whether they intended to provide medical abortions, to provide surgical abortions and to seek abortion training. All students completed surveys during a two-week period in March 2002. The survey took approximately five minutes to complete, and we offered students candy bars as a gesture of gratitude for donating their time to the study; candy was offered to nonparticipants as well to ensure that no incentive would be seen or interpreted as coercion coercion, in law, the unlawful act of compelling a person to do, or to abstain from doing, something by depriving him of the exercise of his free will, particularly by use or threat of physical or moral force. to participate. We promised students total anonymity and confidentiality before they agreed to participate. The majority of students attended classes at the Seattle campus of the university. The lead author administered the surveys in person at the end of a class or seminar; students were approached only once during one class or seminar. First-year physician assistant students in Yakima and Spokane received the same survey, verbal introduction and instructions from two volunteer faculty instructors. A prepaid pre·pay tr.v. pre·paid, pre·pay·ing, pre·pays To pay or pay for beforehand. pre·pay  ment n. self-addressed, stamped envelope allowed each student to securely return
the survey.Data Analysis Responses for general attitudes were transformed from a five-point scale to a three-point scale ("agree," "neither agree nor disagree" and "disagree"). Likewise, responses for intentions and willingness to seek abortion training were coded "yes," "undecided" and "no." We combined family nurse practitioner and nurse-midwifery students into one category labeled as "nursing," as there were few participants in these categories. We used univariate analysis and frequency distributions to describe the overall pattern of responses to survey questions, and bivariate bi·var·i·ate adj. Mathematics Having two variables: bivariate binomial distribution. Adj. 1. analysis to describe attitudes and intentions by program type. We used Pearson's chi-square tests Pearson's chi-square test see chi-square test. to compare categorical That which is unqualified or unconditional. A categorical imperative is a rule, command, or moral obligation that is absolutely and universally binding. Categorical is also used to describe programs limited to or designed for certain classes of people. variables for differences among programs; a p-value of 5% or lower was considered to be statistically significant. To identify factors associated with intention to provide abortion, we conducted multinomial mul·ti·no·mi·al n. See polynomial. [multi- + (bi)nomial.] mul regression analyses, adjusting for selected characteristics (i.e., intended specialty, intended location of practice, age, sex, religion and place of residence in formative formative /for·ma·tive/ (for´mah-tiv) concerned in the origination and development of an organism, part, or tissue. years). RESULTS Demographic Characteristics Of the 363 eligible students, 312 completed our survey, for a response rate of 86%. Forty-seven percent of the sample were medical students, 44% physician assistant students and the remaining 9% nursing students. Consistent with the University of Washington's emphasis on primary care and rural health, 40% of participants planned to pursue a career in family practice and 35% intended to practice in a rural area (Table 1, page 59). Significantly greater proportions of physician assistant and nursing students than of medical students planned to go into family practice (52-54% vs. 24%); a greater proportion of nursing students than of others planned on specializing in obstetrics obstetrics (ŏbstĕ`trĭks), branch of medicine concerned with the treatment of women during pregnancy, labor, childbirth (see birth), and the time after childbirth. , gynecology gynecology (gīn'əkŏl`əjē), branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and maldevelopment of the or women's health Women's Health Definition Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues. (38% vs. 4-5%), whereas a greater proportion of medical students intended to specialize in internal medicine (23% vs. 6%). A greater proportion of physician assistant students than of those in other programs planned on practicing in a rural area (51% vs. 23-34%), and a greater proportion of medical students than of those in other programs intended to practice in an urban area (61% vs. 41%). Half of all students reported living in an urban area during their first 15 years of life. Slightly more than half of the students were younger than 30 (52%) and were female (55%). Medical students tended to be younger than those in other programs, and a greater proportion of nursing students than of those in other programs were female. Thirty-two percent of participants did not report a religious affiliation; 27% were Protestant, 20% were Catholic and 22% were adherents of other religions. Attitudes Toward Abortion Overall, 70-73% of respondents agreed that "elective abortion elective abortion Therapeutic abortion Obstetrics A voluntary interruption of pregnancy before fetal viability, which is performed voluntarily at the request of the mother for reasons unrelated to concerns for maternal or fetal health or welfare; most abortions are should be legal and accessible under any circumstance" and that "it's acceptable for a woman to choose abortion because of a fetal fetal /fe·tal/ (fe´tal) of or pertaining to a fetus or the period of its development. fe·tal adj. Of, relating to, or being a fetus. anomaly Abnormality or deviation. Pronounced "uh-nom-uh-lee," it is a favorite word among computer people when complex systems produce output that is inexplicable. See software conflict and anomaly detection. or congenital disorder congenital disorder A large group of disorders arising during development that cause abnormality of the human body. Most are due to genetic factors such as inherited or spontaneous mutations, whereas others are caused by environmental influences during pregnancy such as " (Table 2); large majorities of students in each program agreed with these views. Forty-three percent neither agreed nor disagreed that they are more comfortable with medical abortion than with surgical abortion. Eighty-three percent of respondents in the nursing program and 57% of respondents in the physician assistant program agreed that advanced clinical practitioners should be able to provide medical abortion, compared with 43% of medical students; overall, 52% agreed with the statement. Similarly, a greater proportion of nursing and physician assistant respondents (72% and 45%, respectively) than of medical students (21%) agreed that advanced clinical practitioners should be able to provide surgical abortion; 37% of all respondents agreed. Sixty-five percent of students agreed that "every program that addresses women's health should include abortion training," without any differences in opinion by program type. Intention to Provide Abortion Thirty-one percent of all respondents intended to provide medical abortion, 23% were undecided and 46% said they would not provide medical abortion (Table 3). By contrast, 18% intended to provide surgical abortion, 24% were undecided and 58% said that they would not provide this service. Twenty-nine percent of respondents reported planning to provide abortions regardless of the patient's reason for terminating the pregnancy, and 90% indicated they would refer a patient to another provider if they were unable or unwilling to provide abortion services. Thirty-four percent of all respondents reported that they would not provide abortion services because it would be outside the scope of their practice (Table 4). Twenty-four percent reported that it is against their religious beliefs, 31% that it is against their personal values and 10% that they will not have the opportunity to be trained in abortion techniques. Small proportions of students believed that they could be ostracized or discriminated against by colleagues (1%), or they or their families might be harassed or threatened (5%) if they performed abortions. The reasons participants were reluctant to provide abortion services were similar across programs, with one exception: Significantly greater proportions of physician assistant and nursing students than of medical students indicated that they would not have the opportunity to be trained in abortion techniques (16-17% vs. 3%). Sixty-four percent of all respondents indicated a willingness to attend a program with a curriculum that requires abortion training (Table 5, page 62), and 55% were willing to take elective courses Noun 1. elective course - a course that the student can select from among alternatives elective course, course of instruction, course of study, class - education imparted in a series of lessons or meetings; "he took a course in basket weaving"; "flirting is in abortion training. A quarter of students indicated an intention to seek a residency A duration of stay required by state and local laws that entitles a person to the legal protection and benefits provided by applicable statutes. States have required state residency for a variety of rights, including the right to vote, the right to run for public office, the program or practicum practicum (prak´tik  m),n See internship. site that includes abortion training. In the fully adjusted multinomial model, the likelihood of intending to incorporate surgical abortion into practice was strongly associated with an intention to pursue a career in obstetrics and gynecology obstetrics and gynecology Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. or women's health, as well as the belief that advanced clinical practitioners should be allowed to provide surgical abortions (not shown). The beliefs that abortion was "outside the scope of practice" and "against personal values" were significantly associated with not intending to provide surgical or medical abortions; however, religious affiliation was not associated with these outcomes. A marginally significant difference suggested that women may be more likely than men to intend to provide medical and surgical abortions. DISCUSSION To our knowledge, this study is the first of its kind to compare attitudes and intentions of different types of future health care professionals regarding both medical and surgical abortion, and to specifically examine the potential role of future advanced clinical practitioners in providing these services. Strikingly high proportions of future health care providers at the University of Washington indicated an intention to provide medical abortions and surgical abortions in their practices. Although some of the decrease in the number of abortion providers may be because of the high-profile incidence of clinic violence in recent years, (10) surprisingly small proportions of survey respondents believed they or their family would be harassed, or they might be discriminated against by colleagues, if they provided abortion services. Thus, the targeted violence against abortion providers may not impact future health care providers' willingness to incorporate abortion services into their practice. However, our findings may also reflect the relatively liberal laws governing abortion provision in the state of Washington, and the relatively low incidence of violent activities of antiabortion an·ti·a·bor·tion adj. Opposed to induced abortion: the antiabortion movement. an extremists there. (11) Our finding that a substantial proportion of students believed that abortion training should be a standard part of women's health training was unexpected, given the largely marginalized status of abortion education in academic medical centers. (12) Although a greater proportion of future health care providers planned to provide medical abortion than surgical abortions, the majority of students did not indicate being more comfortable with medical abortion than with surgical abortion. This may be because medical abortion is a newer and less familiar option. Alternatively, students may not differentiate between types of procedures. Students' intentions to provide medical rather than surgical abortion and their endorsement of advanced clinical practitioners' provision of medical abortion may also reflect the perception that medical abortion requires less complicated clinical training than surgical abortion. Perhaps the most notable findings of our study were the avid AVID Cardiology A clinical trial–Antiarrhythmics Versus Implantable Defibrillators that compared the effect of implantable defibrillators vs the best medical therapy–antiarrhythmics for survivors of MI or those with nonsustained ventricular tachycardia interest among advanced clinical practitioners in providing both medical and surgical abortions, and their belief that they should be permitted to provide these services. Such change will likely require support from the physician community. However, medical students were less enthusiastic than respondents from other programs about supporting nonphysician provision of abortion, possibly because they perceive this procedure to be outside the scope of training for advanced clinical practitioners or they are concerned about protecting their own clinical territory. Laws restricting provision of abortion procedures to physicians were originally intended to protect women from providers of unsafe abortions Unsafe abortion is a significant cause of maternal mortality and morbidity in the world, especially in developing countries (95% of unsafe abortions take place in developing countries). after the legalization LEGALIZATION. The act of making lawful. 2. By legalization, is also understood the act by which a judge or competent officer authenticates a record, or other matter, in order that the same may be lawfully read in evidence. Vide Authentication. of abortion in 1973; they were not meant to limit the services of qualified health care practitioners. However, as the use of advance clinical practitioners is becoming increasingly common in health care, these laws may no longer be well justified and, instead, may contribute to the lack of abortion providers in the majority of U.S. counties, particularly in rural areas. Our study has several limitations. Foremost, intention to provide abortion services may not directly predict provision, and we cannot track the students' careers, given the anonymous nature of this study. Furthermore, the constant flux flux In metallurgy, any substance introduced in the smelting of ores to promote fluidity and to remove objectionable impurities in the form of slag. Limestone is commonly used for this purpose in smelting iron ores. in policies regarding abortion and health care providers' scope of practice may impact providers' ability to perform abortion. This issue may be especially relevant to physicians in specialties other than obstetrics and gynecology, and to nonphysician providers. Second, the findings may not be generalizable gen·er·al·ize v. gen·er·al·ized, gen·er·al·iz·ing, gen·er·al·iz·es v.tr. 1. a. To reduce to a general form, class, or law. b. To render indefinite or unspecific. 2. to other future health care providers. The WWAMI WWAMI Washington, Wyoming, Alaska, Montana, Idaho (regional medical education program) program at the University of Washington Health Sciences campus provided an excellent opportunity to access a large student body representing a vast geographic area. However, the university has a greater focus on primary and rural health care than most health professional schools and a history of offering abortion training to obstetrics, gynecology and family practice residents. Therefore, these students may not represent all health sciences students across the country. In addition, attitudes toward abortion may be more liberal in the Pacific Northwest than in other regions of the United States. (13) Finally, in our sample, there were fewer nursing students than physician assistant or medical students. The nursing students in this study were recruited from the family nurse practitioner and the nurse-midwifery programs, both of which are highly specialized. However, overall findings of the study were essentially unchanged when we excluded nursing students from the analyses; moreover, given their focus on women's reproductive health Within the framework of WHO's definition of health[1] as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene , their inclusion was important to the study. In conclusion, this study demonstrates that the majority of future health professionals in the allied health sciences at the University of Washington believe that abortion should be legal, accessible and a standard part of clinical training. Many also believe that advanced clinical practitioners, such as physician assistants, nurse practitioners and nurse-midwives, should have a role in expanding access to abortion services, especially medical abortion. Although it may not be possible or desirable to require abortion training for every future health care provider, making abortion a standard part of clinical training will open avenues for both future physicians and advanced clinical practitioners who are in favor of providing these services. More important, expanding abortion training in the allied health professions will likely alleviate the abortion provider shortage.
TABLE 1. Percentage distribution of respondents to a survey
of University of Washington health sciences students, by
selected characteristics, according to program of study, 2002
Characteristic All Medicine Physician Nursing
(N=312) (N=147) assistant (N=29)
(N=136)
Intended specialty
Family practice 39.8 24.1 *** 54.1 51.7
Obstetrics-gynecology/
women's health 7.4 3.5 5.2 38.0 ***
Pediatrics 5.5 8.9 3.0 0.0
Internal medicine 13.3 22.8 *** 5.9 0.0
Other ([dagger]) 34.0 40.7 31.8 10.3
Intended location of practice
([double dagger])
Rural 35.3 23.1 50.7 *** 24.1
Urban 50.3 60.5 *** 41.2 41.4
Other 15.4 17.0 10.3 31.0 *
Residence through age 15
([double dagger])
Rural 38.5 34.7 43.4 34.5
Urban 52.6 55.1 48.5 58.6
Other 11.5 12.2 11.0 10.3
Age
18-23 6.7 13.6 *** 0.0 3.4
24-29 45.5 74.2 *** 18.0 27.6
30-35 22.3 10.2 *** 34.3 27.6
[greater than or equal to] 36 25.5 2.0 *** 47.7 41.4
Sex
Female 55.0 51.7 51.1 92.6 ***
Male 45.0 48.3 48.9 7.4
Religion
Protestant 26.7 28.6 23.5 31.0
Catholic 19.6 23.1 17.6 10.3
None 31.5 33.3 29.4 31.0
Other 22.2 15.0 *** 26.5 27.6
Total 100.0 100.0 100.0 100.0
* Differs from percentages in other groups at p5.05. *** Differs from
percentages in other groups at p[less than or equal to].001. ([dagger])
Includes "undecided." ([double dagger]) Percentages may add to more
than 100% because some participants intend to practice in or lived in
more than one geographic area. Notes: In cases where responses were
missing, these were excluded from the denominator.
TABLE 2. Percentage distribution of survey respondents, by agreement
with statements reflecting general attitudes toward according to
program of study
Statement All
Agree Neither Disagree
agree
nor
disagree
Elective abortion
should be legal and
accessible under
any circumstance 69.8 3.2 26.9
It's acceptable for a
woman to choose
abortion because
of a fetal anomaly or
congenital disorder 72.8 9.6 17.6
I am more comfortable
with medical abortion
than surgical abortion 35.1 43.4 21.5
Advanced clinical
providers should be
able to provide
medical abortion 52.4 15.4 32.2
Advanced clinical
providers should be
able to provide
surgical abortion 36.6 18.1 45.3
Every program that
addresses women's
health should include
abortion training 64.7 9.5 25.8
Statement Medicine
Agree Neither Disagree
agree
nor
disagree
Elective abortion
should be legal and
accessible under
any circumstance 72.1 3.4 24.5
It's acceptable for a
woman to choose
abortion because
of a fetal anomaly or
congenital disorder 70.1 10.2 19.7
I am more comfortable
with medical abortion
than surgical abortion 36.0 39.5 24.5
Advanced clinical
providers should be
able to provide
medical abortion 42.5 *** 15.1 42.5
Advanced clinical
providers should be
able to provide
surgical abortion 21.4 *** 16.5 62.1
Every program that
addresses women's
health should include
abortion training 63.6 9.8 26.6
Statement Physician assistant
Agree Neither Disagree
agree
nor
disagree
Elective abortion
should be legal and
accessible under
any circumstance 64.7 3.6 31.6
It's acceptable for a
woman to choose
abortion because
of a fetal anomaly or
congenital disorder 74.4 9.6 16.2
I am more comfortable
with medical abortion
than surgical abortion 36.3 43.7 20.0
Advanced clinical
providers should be
able to provide
medical abortion 56.6 17.7 25.7
Advanced clinical
providers should be
able to provide
surgical abortion 45.2 22.2 32.6
Every program that
addresses women's
health should include
abortion training 65.8 9.0 25.3
Statement Nursing
Total
Agree Neither Disagree
agree
nor
disagree
Elective abortion
should be legal and
accessible under
any circumstance 82.8 0.0 17.2 100.0
It's acceptable for a
woman to choose
abortion because
of a fetal anomaly or
congenital disorder 79.3 6.9 13.8 100.0
I am more comfortable
with medical abortion
than surgical abortion 24.1 62.1 13.8 100.0
Advanced clinical
providers should be
able to provide
medical abortion 82.8 6.9 10.3 100.0
Advanced clinical
providers should be
able to provide
surgical abortion 72.4 6.9 20.7 100.0
Every program that
addresses women's
health should include
abortion training 65.5 10.3 24.1 100.0
*** Differs from percentage agreeing in other groups at p[less than or
equal to].001. Notes: "Strongly agree" and "somewhat agree" were
combined and labeled "agree". "Strongly disagree" and "somewhat
disagree" were combined and labeled "disagree." In cases where
responses were missing these were excluded from the denominator.
TABLE 3. Percentage distribution of survey respondents, by agreement
with statements reflecting intention to provide abortion services,
according to program of study
Statement All Medicine
Yes Un- No Yes Un- No
decided decided
I plan to incorporate
medical abortion
into my practice 31.2 23.1 45.7 32.9 21.9 45.2
I plan to incorporate
surgical abortion
into my practice 18.0 24.1 57.9 19.2 26.7 54.1
I plan to perform
abortion for my
patients regardless
of their reasons
for terminating a
pregnancy 28.6 17.4 54.0 30.8 19.2 50.0
I would be willing to
refer patients
inquiring about an
abortion to other
clinics or providers
if necessary 90.4 4.5 5.1 91.8 3.4 4.8
Statement Physician assistant Nursing Total
Yes Un- No Yes Un- No
decided decided
I plan to incorporate
medical abortion
into my practice 25.7 24.3 50.0 48.3 24.1 27.6 100.0
I plan to incorporate
surgical abortion
into my practice 16.2 22.1 61.7 20.7 20.7 58.6 100.0
I plan to perform
abortion for my
patients regardless
of their reasons
for terminating a
pregnancy 22.8 16.9 60.3 44.8 10.3 44.8 100.0
I would be willing to
refer patients
inquiring about an
abortion to other
clinics or providers
if necessary 89.0 5.9 5.1 89.7 3.4 6.9 100.0
Notes: "Probably yes" and "definitely yes" were combined and labeled
"yes." "Probably not" and "definitely not" were combined and labeled
"no."
TABLE 4. Percentage of survey respondents giving selected reasons for
not intending to provide abortion services, by program of study
Reason All Medicine Physician Nursing
assistant
It will be outside the
scope of my practice 33.7 35.4 34.6 20.7
It's against my
religious beliefs 24.0 24.5 24.3 20.7
It's against my personal
values 31.4 32.7 32.4 20.7
I will not have the
opportunity to be trained
in abortion techniques 10.3 3.4 ** 16.2 17.2
I may be ostracized by my
colleagues and/or
discriminated against in
my profession 1.3 0.0 1.5 3.5
I fear that either I or my
family may be harassed
and/or threatened by others 4.8 4.1 5.2 6.9
** Differs from other groups at p<.0l. Note: Respondents could
give more than one answer.
TABLE 5. Percentage distribution of survey respondents, by agreement
with statements reflecting willingness to seek abortion training,
according to program of study
Statement All Medicine
Yes Un- No Yes Un- No
decided decided
I am willing to
attend a program
that requires
abortion training
in the curriculum 63.8 10.9 25.0 69.4 11.6 19.1
I am willing to take
elective courses
in abortion
training 54.8 9.3 35.9 54.4 12.2 33.3
I will seek a
residency program
or practicum site
that specifically
includes abortion
training 24.0 22.8 52.6 28.1 25.3 46.6
Statement Physician assistant Nursing
Total
Yes Un- No Yes Un- No
decided decided
I am willing to
attend a program
that requires
abortion training
in the curriculum 57.0 11.1 31.9 69.0 6.9 24.1 100.0
I am willing to take
elective courses
in abortion
training 52.2 8.1 39.7 69.0 0.0 31.0 100.0
I will seek a
residency program
or practicum site
that specifically
includes abortion
training 17.0 22.2 60.7 37.9 13.8 48.3 100.0
Notes: "Probably yes" and "definitely yes were" combined and labeled
"yes." "Probably not" and definitely not were combined and labeled
"no."
Acknowledgment acknowledgment, in law, formal declaration or admission by a person who executed an instrument (e.g., a will or a deed) that the instrument is his. The acknowledgment is made before a court, a notary public, or any other authorized person. This study was supported in part by a grant from the Maternal and Child Health Bureau, Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency within the United States Department of Health and Human Services whose goal is to improve access to health care for those without insurance. , U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS . Author contact: solmazs@u.washington.edu * The University of Washington's WWAMI program--dedicated to providing medical education to students from Washington, Wyoming, Alaska, Montana and Idaho--gives first-year medical students the option of taking their basic studies at their state institutions, attending the University of Washington School of Medicine for their second year and then completing their third and fourth years in community settings. REFERENCES (1.) The Alan Guttmacher Alan Frank Guttmacher (1898-1974) was an American physician. He served as president of Planned Parenthood and vice-president of the American Eugenics Society, founded the Association for the Study of Abortion in 1964, was a member of the Association for Voluntary Institute (AGI (Artificial General Intelligence) A machine intelligence that resembles that of a human being. Considered impossible by many, most artificial intelligence (AI) research, projects and products deal with specific applications such as industrial robots, playing chess, ), Sharing Responsibility: Women, Society and Abortion Worldwide, New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : AGI, 1999. (2.) Finer LB and Henshaw J, Abortion incidence and services in the United States in 2000, Perspectives on Sexual and Reproductive Health, 2003, 35(1):6-15. (3.) Henshaw SK, Unintended pregnancy in the United States, Family Planning family planning Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. Perspectives, 1998, 30(1):24-29 & 46. (4.) Ibid. (5.) Finer LB and Henshaw SK, 2003, op. cit. (see reference 2). (6.) Ibid.; Foster AM, van Dis J and Steinauer J, Educational and legislative initiatives affecting residency training in abortion, Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 2003, 290(13):1777-1778; Kaiser Family Foundation The Henry J. Kaiser Family Foundation (KFF), or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. (KFF KFF Kaiser Family Foundation KFF Kenya Football Federation KFF King Faisal Foundation KFF Kerrville Folk Festival KFF Kung Fu Fighting KFF Key Flexfield (Oracle) KFF Kellogg's Frosted Flakes (cereal) ), National Survey of Obstetricians/Gynecologists on Contraception contraception: see birth control. contraception Birth control by prevention of conception or impregnation. The most common method is sterilization. The most effective temporary methods are nearly 99% effective if used consistently and correctly. and Unplanned Pregnancy: Attitude and Practices with Regard to Abortions, Menlo Park Menlo Park. 1 Residential city (1990 pop. 28,040), San Mateo co., W Calif.; inc. 1874. Electronic equipment and aerospace products are manufactured in the city. Menlo College and a Stanford Univ. research institute are there. 2 Uninc. , CA: KFF, 1995; Grimes Grimes is a surname, that is believed to be of a Scandinavian decent and may refer to
(7.) Narrigan D, Early abortion early abortion Obstetrics An abortion performed before the 12th wk of gestation. See Abortion. : update and implications for midwifery midwifery (mĭd`wī'fərē), art of assisting at childbirth. The term midwife for centuries referred to a woman who was an overseer during the process of delivery. In ancient Greece and Rome, these women had some formal training. practice, Journal of Nurse-Midwifery, 1998, 43(6):492-501. (8.) Ibid.; McKee K and Adams E, Nurse midwives' attitudes toward abortion performance and related procedures, Journal of Nurse-Midwifery, 1994, 39(5):300-311; Freedman freed·man n. A man who has been freed from slavery. freedman Noun pl -men History a man freed from slavery Noun 1. M et al., Comparison of complication complication /com·pli·ca·tion/ (kom?pli-ka´shun) 1. disease(s) concurrent with another disease. 2. occurrence of several diseases in the same patient. com·pli·ca·tion n. rates in first trimester Noun 1. first trimester - time period extending from the first day of the last menstrual period through 12 weeks of gestation trimester - a period of three months; especially one of the three three-month periods into which human pregnancy is divided abortions performed by physician assistants and physicians, American Journal of Public Health The American Journal of Public Health (AJPH) is a peer reviewed monthly journal of the American Public Health Association (APHA). The Journal also regularly publishes authoritative editorials and commentaries and serves as a forum for the analysis of health policy. , 1986, 76(5):550-554; and National Abortion and Reproductive Rights Reproductive rights or procreative liberty is what supporters view as human rights in areas of sexual reproduction. Advocates of reproductive rights support the right to control one's reproductive functions, such as the rights to reproduce (such as opposition to forced Action League (NARAL NARAL National Abortion and Reproductive Rights Action League ), Who Decides? A State-by-State Review of Abortion and Reproductive Rights, 10th ed., Washington, DC: NARAL, 2001. (9.) Rosenblatt R et al., Medical students' attitudes toward abortion and other reproductive health services, Family Medicine, 1999, 31(3): 195-199; Stennett R and Bongiovi M, Future physicians' attitudes on women's reproductive rights: a survey of medical students in an American university American University, at Washington, D.C.; United Methodist; founded by Bishop J. F. Hurst, chartered 1893, opened in 1914. It was at first a graduate school; an undergraduate college was opened in 1925. Programs provide for student research at many government institutions. , Journal of the American Medical Women's Association, 1991, 46(6):178-181; and Klamen D, Grossman L and Kopacz K, Attitudes about abortion among second-year medical students, Medical Teacher, 1996, 18(4):345-346. (10.) Finer LB and Henshaw SK, 2003, op. cit. (see reference 2). (11.) AGI, State facts about abortion: Washington, <http://agi-usa.org/ pubs/sfaa/washington.html>, accessed Mar. 22, 2004; NARAL Pro-Choice America NARAL Pro-Choice America, founded in 1969 as the National Abortion and Reproductive Rights Action League, is a nonprofit organization that was formed primarily to maintain a woman's legal right to have an abortion. , Who decides? state profiles: Washington, <http:// www.naral.org/yourstate/whodecides/states/washington/ summary.cfm>, accessed Mar. 22, 2004; Finer LB and Henshaw SK, 2003, op. cit. (see reference 2); National Abortion Federation The National Abortion Federation (NAF) is an organization of abortion providers. Though originally a U.S. group, NAF has expanded to include practitioners in Canada and Australia as well as many European countries. (NAF NAF National Arbitration Forum NAF National Academy Foundation NAF National Abortion Federation NaF sodium fluoride NAF Naval Air Facility NAF National Ataxia Foundation NAF New America Foundation (think tank) ), Violence statistics, <http://www.prochoice.org/violence/history/chron_arson arson, at common law, the malicious and willful burning of the house of another. Originally, it was an offense against the security of habitation rather than against property rights. . asp>, accessed Mar. 22, 2004; and Saul R, State clinic access laws largely mirror FACE statute; high court sets rules on buffer zones buffer zone n. A neutral area between hostile or belligerent forces that serves to prevent conflict. Noun 1. buffer zone , State Reproductive Health Monitor, 1997, 8(1), <http://www.guttmacher.org/ pubs/journals/srhm0497.html>, accessed Mar. 22, 2004. (12.) MacKay HT and MacKay AP, Abortion training in obstetrics and gynecology residency programs in the United States, 1991-1992, Family Planning Perspectives, 1995, 27(3):112-115; Almeling R, Tews L and Dudley S Dudley, city (1991 pop. 186,513) and metropolitan district, W central England. Dudley's famed iron, coal, and limestone industries began declining c.1870. Other industries include engineering works, steelworks, metallurgy, glass cutting, textiles, and leatherworking. , Abortion training in U.S. obstetrics and gynecology residency programs, 1998, Family Planning perspectives, 2000, 32(6):268-271 & 320; and Joffe C, Roe v. Wade Roe v. Wade, case decided in 1973 by the U.S. Supreme Court. Along with Doe v. Bolton, this decision legalized abortion in the first trimester of pregnancy. at 30: What Are the Prospects for Abortion Provision? Perspectives on Sexual and Reproductive Health, 2003, 35(1):29-33. (13.) AGI, State facts about abortion: Washington, op cit Op Cit Opere Citato (Latin: In the Work Mentioned) . (see reference 11); NARAL Pro-choice America, Who decides? state profiles: Washington, op. cir. (see reference 11); Finer LB and Henshaw SK, 2003, op. cir. (see reference 2); NAF, Violence statistics, op. cit. (see reference 11); and Saul R, 1997, op. cit. (see reference 11). Solmaz Shotorbani is research study coordinator, Department of Pharmacy; Frederick J. Zimmerman is co-director, Child Health Institute, and assistant professor of health services health services Managed care The benefits covered under a health contract ; Janice F. Bell is a doctoral student, School of Public Health, Department of Health Services Department of Health Services may refer to:
psy·cho·so·cial adj. Involving aspects of both social and psychological behavior. and community health, School of Nursing--all at the University of Washington, Seattle. Nassim Assefi is health refresher training Refresher training is a form of updating military knowledge of the reservist troops. After one has completed the conscription service, he or she can be called for refresher training for some amount of days. advisor, Management Sciences for Health, Kabul, Afghanistan. |
|
||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion