Providing accessible medical abortion services in a Victorian rural community: A description and audit of service delivery and contraception follow up.

OBJECTIVE

To describe how a nurse led, MToP service is run in primary care in regional Victoria and investigate the characteristics and contraceptive choices of the women who have attended.

STUDY DESIGN

Descriptive study of the development and implementation of a rural MToP service and a retrospective chart audit of patients attending between January 2015 and September 2016.

MAIN OUTCOME MEASURES

Characteristics and clinical outcomes for women attending an MToP service in a primary care setting in rural Victoria. Contraceptive usage pre and post attending a rural service for MToP.

RESULTS

There were 229 presentations, representing 223 women, of which 172 women (75.1%; 95%CI: 69.0%, 80.6%) had a successful MToP and for two further women, MToP failed, requiring a surgical termination (0.9%; 95%CI: 0.1%, 3.1%). At the time of presentation, the mean age of women was 25 years, the median length of gestation was 49 days and 171 (75%) had not had a previous termination. Data about contraceptive use was available for 195 women, 143 (73.3%) reported no contraception, 2 reported emergency contraceptive pill (1.0%), 10 used condoms (2.1%) and 39 (20.0%) reported hormonal contraception. Among the 156 women using no contraception, condoms or emergency contraception at the time of pregnancy, 113 (72.4%) initiated a reliable form of contraception post presentation to the MToP service.

CONCLUSION

Provision of accessible, affordable MToP through an integrated primary health service is one strategy to address access inequity in regional areas.