影响安大略省堕胎服务提供的因素：一项描述性研究。

Ferris L E, McMain-Klein M, Iron K

Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Canada.

Fam Plann Perspect. 1998 May-Jun;30(3):134-8.

CONTEXT

Although Canadian women have had the right to obtain legal induced abortions for the past decade, access to the procedure is still limited and controversial in many areas.

METHODS

Chiefs of obstetrics and gynecology, chiefs of staff, directors of nursing and other health professionals at 163 general hospitals in Ontario, Canada, were asked to provide information on issues concerning the availability of abortion services of their facility. The hospital participation rate was 97% and the individual response rate was 75%.

RESULTS

Nearly one-half (48%) of hospitals perform abortions. Approximately 36% of these hospitals do so up to a maximum gestational age of 12 weeks, 23% to a maximum of 13-16 weeks, 37% to a maximum of 17-20 weeks and 4% at greater than 20 weeks. Hospital factors, including resources and policies, did not significantly influence whether abortions are provided. However, these factors did affect the number performed, whether there were gestational limitations and the choice of procedure. About 13% of provider hospitals indicated that staff training contributes to the existence of gestational age limits, and 24% said that it directly influences procedure choice. Only 18% of hospitals reported that their physicians have received additional training outside of their medical school or medical residency education to learn abortion techniques or to gain new skills. Forty-five percent of hospitals that provide abortions had experienced harassment within the past two years, and 15% reported that this harassment has directly affected their staff members' willingness to provide abortions.

CONCLUSION

Based upon the provision of obstetric care, many hospitals in Ontario that are capable of offering abortion services do not. Some of the reasons for this failure are related to the procedure itself, while others may be related to resource issues that affect the delivery of other medical services as well. Variation in the availability of abortions is due to a shortage of clinicians performing the procedure, and training directly influences gestational limits and procedural choices.

背景

尽管在过去十年中加拿大女性有权依法进行人工流产，但在许多地区，获得该手术的途径仍然有限且存在争议。

方法

研究人员向加拿大安大略省163家综合医院的妇产科主任、医务主任、护理主任及其他医疗专业人员询问了有关其所在机构堕胎服务可及性问题的信息。医院参与率为97%，个人回复率为75%。

结果

近一半（48%）的医院进行堕胎手术。其中约36%的医院将堕胎手术的最大孕周限制在12周，23%的医院为13至16周，37%的医院为17至20周，4%的医院则超过20周。包括资源和政策在内的医院因素对是否提供堕胎服务没有显著影响。然而，这些因素确实影响了堕胎手术的数量、是否存在孕周限制以及手术方式的选择。约13%的提供堕胎服务的医院表示，员工培训导致了孕周限制的存在，24%的医院称其直接影响手术方式的选择。只有18%的医院报告称，其医生在医学院或住院医师培训之外接受了额外培训以学习堕胎技术或获得新技能。45%提供堕胎服务的医院在过去两年中遭受过骚扰，15%的医院报告称这种骚扰直接影响了其工作人员提供堕胎服务的意愿。