Finer Lawrence B, Wei Junhow
From the Guttmacher Institute, New York, New York.
Obstet Gynecol. 2009 Sep;114(3):623-630. doi: 10.1097/AOG.0b013e3181b2a74d.
To examine the pattern of mifepristone uptake in the United States and whether the introduction of this drug has facilitated access to abortion services.
Using data from a national census of abortion providers and from the U.S. distributor of mifepristone, we assessed the number and proportion of abortions performed using mifepristone, the distribution of mifepristone providers by provider type and medical specialty, and the geographic distribution of mifepristone and surgical providers.
The number of mifepristone providers increased from 208 in the last 2 months of 2000 to 700 in 2001, the first full year of availability, and to 902 in 2007. Some 158,000 mifepristone abortions were performed in 2007, representing an estimated 14% of all abortions and 21% of eligible early abortions. Physicians represented 51% of mifepristone providers but accounted for just 11% of abortions; most were obstetrician-gynecologists. The proportion of abortions in each state performed using mifepristone ranged from 0% to 80%. Most mifepristone abortions were performed at or near facilities that also provided surgical abortion. Only five mifepristone-only providers of 10 or more abortions were located farther than 50 miles from any surgical provider of 400 or more abortions.
Mifepristone has become an integral part of abortion provision in the United States and likely has contributed to a trend toward very early abortions. However, expectations that approval of mifepristone would result in a wider range of providers offering abortion have not yet been met, and mifepristone has not brought a major improvement in the geographic availability of abortion.
III.
研究美国米非司酮的使用模式，以及该药物的引入是否促进了堕胎服务的可及性。
利用来自全国堕胎服务提供者普查的数据以及米非司酮在美国的经销商的数据，我们评估了使用米非司酮进行堕胎的数量和比例、按提供者类型和医学专业划分的米非司酮提供者分布情况，以及米非司酮提供者和手术堕胎提供者的地理分布。
米非司酮提供者的数量从2000年最后两个月的208家增加到2001年（可使用的第一年）的700家，并在2007年增至902家。2007年约有15.8万例使用米非司酮的堕胎，约占所有堕胎的14%，占符合条件的早期堕胎的21%。医生占米非司酮提供者的51%，但仅占堕胎的11%；大多数是妇产科医生。每个州使用米非司酮进行堕胎的比例从0%到80%不等。大多数使用米非司酮的堕胎是在也提供手术堕胎的机构或其附近进行的。在距离任何进行400例或更多手术堕胎的提供者50英里以上的地方，只有5家仅提供米非司酮且堕胎10例或更多的提供者。
米非司酮已成为美国堕胎服务的一个组成部分，并且可能促成了极早期堕胎的趋势。然而，米非司酮获批会导致更多提供者提供堕胎服务的期望尚未实现，而且米非司酮并未在堕胎服务的地理可及性方面带来重大改善。
III级。
