Miller N H, Miller D J, Pinkston Koenigs L M
Department of Pediatrics, Baystate Medical Center, Springfield, MA 01199, USA.
Pediatrics. 1998 May;101(5):E4. doi: 10.1542/peds.101.5.e4.
To document the practices and attitudes of the US physician members of the Society for Adolescent Medicine (SAM) regarding adolescent abortion and contraception, as well as physician willingness to prescribe medical abortion if approved by the Food and Drug Administration (FDA).
Cross-sectional questionnaire survey. Participants. The entire physician membership of SAM (N = 1001) was surveyed. A total of 713 physicians responded, with 668 usable surveys yielding an adjusted response rate of 70%.
Of the respondents, 81% were trained as pediatricians; 58% had additional adolescent medicine training. Ninety-six percent prescribed contraception for their patients. Sixty-one percent of respondents identified abortion as an option for pregnant adolescents in all circumstances, whereas 4% believed abortion should never be an option. Eighty-nine percent referred their patients for abortions; 90% were aware of medications to induce abortions medically. If these medications (methotrexate and misoprostol, RU-486) were FDA-approved, 42% would prescribe them for their patients; 34% were unsure. Fifty-four percent believed if medical abortions were routinely available, they should be available from primary care physicians. Physicians were significantly more likely to consider prescribing medical abortions if the physician were female, offered postcoital contraception, performed Norplant insertions, referred adolescents for abortions, or performed postabortion medical checkups. Physicians were no more likely to consider prescribing medical abortions according to physician age, specialty training, or date of residency training. Religious affiliation per se was not associated with likelihood of prescribing medical abortions, but Catholic physicians were significantly less likely to consider prescribing medical abortions.
Virtually all SAM physician respondents (96%) reported that abortion for pregnant adolescents should be available under some circumstances. Forty-two percent would prescribe medical abortion if the medications were FDA-approved, suggesting that medical abortion would potentially be available to adolescents from a larger group of physicians than is currently available.
记录美国青少年医学协会(SAM)的医生会员在青少年堕胎和避孕方面的做法及态度,以及医生在药物流产获美国食品药品监督管理局(FDA)批准后开具此类处方的意愿。
横断面问卷调查。参与者:对SAM的全体医生会员(N = 1001)进行了调查。共有713名医生回复,668份问卷可用,调整后的回复率为70%。
在回复者中,81%接受过儿科医生培训;58%接受过额外的青少年医学培训。96%的医生为患者开具避孕药。61%的回复者认为在所有情况下堕胎都是怀孕青少年的一种选择,而4%的人认为堕胎绝不应成为一种选择。89%的医生会为患者安排堕胎转诊;90%的医生知晓药物流产药物。如果这些药物(甲氨蝶呤和米索前列醇、RU - 486)获FDA批准,42%的医生会为患者开具;34%的医生不确定。54%的医生认为如果药物流产常规可用,应能从初级保健医生处获得。如果医生为女性、提供性交后避孕、进行诺普兰植入、为青少年安排堕胎转诊或进行堕胎后医学检查,那么他们更有可能考虑开具药物流产处方。医生考虑开具药物流产处方的可能性与医生年龄、专业培训或住院医师培训日期无关。宗教信仰本身与开具药物流产处方的可能性无关,但天主教医生考虑开具药物流产处方的可能性显著较低。
几乎所有SAM医生回复者(96%)都表示在某些情况下应为怀孕青少年提供堕胎服务。如果药物获FDA批准,42%的医生会开具药物流产处方,这表明与目前相比,更多医生可能会为青少年提供药物流产服务。