STAFF ATTITUDES TOWARD PROVIDING MEDICATION ABORTION IN PRIMARY CARE SETTINGS

Abstract

Objectives

We assessed baseline staff attitudes toward providing medication abortion in 10 primary care clinics participating in a program to adopt medication abortion.

Methods

In 2024, staff champions from 10 organizations in eight states administered our online survey to staff at clinics preparing to introduce medication abortion (n=908). Eligibility criteria included non-champion staff who could directly or indirectly be involved in a medication abortion visit. Surveys queried on perspectives related to medication abortion acceptability and belonging in primary care, comfort working in a clinic providing it, and open-ended questions on benefits and concerns. We organized open-ended responses into common themes. We conducted regression analysis using cluster-robust standard errors to explore staff characteristics associated with medication abortion attitudes.

Results

Some 721 responded (79.4%); 454 met eligibility criteria. Some 387 (85.2%) believed medication abortion should be available in primary care; only 75 (16.5%) felt uncomfortable working in a clinic that provides it. Significant differences between organizations exist across all outcomes (p<0.04). After we controlled for clustering within organizations, acceptability of medication abortion implementation scores were significantly higher among participants at academic and community health centers than at federally qualified health centers (p<0.01); lower among those working in non-LGBTQ-specific clinics (p<0.001); and lower among patient-facing clinic staff than among providers (p<0.01). Perceived benefits included mitigating access barriers (50.5%), aligning with primary care values (36.8%), and promoting reproductive autonomy (10.6%). Concerns included safety risks (34.2%), training (28.2%), and staff opposition (17.6%). Some 31.3% explicitly stated no concerns.

Conclusions

Most staff at these primary care clinics are supportive of providing medication abortion, but have concerns that champions should address during implementation.