Article
Health Care Sciences & Services
Sarah Munro, Kate Wahl, Judith A. Soon, Edith Guilbert, Elizabeth S. Wilcox, Genevieve Leduc-Robert, Nadra Ansari, Courtney Devane, Wendy Norman
Summary: The study on Canadian pharmacists showed that they are willing and able to participate in medical abortion care, with factors such as Diffusion of Innovation and integrated knowledge translation influencing their decision. The findings also highlighted the safety and acceptance of mifepristone dispensed by pharmacists outside of traditional healthcare settings, which is particularly important during the current COVID-19 pandemic.
IMPLEMENTATION SCIENCE
(2021)
Article
Obstetrics & Gynecology
H. Norten, O. Ilozumba, J. Wilkinson, K. Gemzell-Danielsson, R. Gomperts
Summary: The study results show an increase in the rate of complete abortions and a decrease in surgical interventions for telemedical abortion in the last 10 years. Despite the limitation of low follow-up rates, it is evident that this method is highly acceptable worldwide.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2022)
Article
Medicine, General & Internal
Patricia J. Zettler, Lewis A. Grossman, Eli Y. Adashi, I. Glenn Cohen
Summary: This article discusses the opinion issued by the federal appeals court in the case of Alliance for Hippocratic Medicine v FDA, and its impact on the approval and regulation of mifepristone. The appeals court did not completely halt the marketing of mifepristone, but it deemed the FDA's actions in 2016 and 2021 potentially unlawful and affirmed the order to stay these actions.
ANNALS OF INTERNAL MEDICINE
(2023)
Article
Environmental Sciences
Yu-Ting Su, Jia-Shing Chen, Yi-Ru Tsai, Kuo-Chung Lan, Cheng-Chun Wu, Fu-Jen Huang
Summary: Mifepristone directly affects blastocyst viability and inhibits post-implantation embryo development in mice. The study suggests a potential risk of fetus fatality and developmental problems when pregnancies are continued after mifepristone treatment fails.
Article
Obstetrics & Gynecology
Patricia Horgan, Mike Thompson, Ken Harte, Robert Gee
Summary: The study demonstrates that the general-practitioner-delivered community medical abortion service in Ireland is safe, effective, and accessible for the majority of women seeking abortion. Most women adopted contraception post abortion, providing an ideal opportunity to discuss contraceptive choice.
Article
Biochemistry & Molecular Biology
Yu-Ting Su, Jia-Shing Chen, Kuo-Chung Lan, Yung-Kuo Lee, Tian-Huei Chu, Yu-Cheng Ho, Cheng-Chun Wu, Fu-Jen Huang
Summary: The clinical use of mifepristone for medical abortions has been established in France in 1987 and in the United States in 2000. Mifepristone functions as an antagonist for progesterone and glucocorticoid receptors and can cause endometrial degeneration. However, its direct effects on embryo survival and growth are still unclear. This study found that mifepristone treatment significantly altered the cellular pathways of embryos, leading to decreased viability, proliferation, and development. Continuing a pregnancy after mifepristone treatment fails is inappropriate and comes with a high risk of fetus fatality and developmental problems.
Article
Medicine, General & Internal
Margit Endler, Gregory Petro, Kristina Gemzell Danielsson, Dan Grossman, Rebecca Gomperts, Maja Weinryb, Deborah Constant
Summary: In a randomized controlled non-inferiority trial conducted in South Africa, the use of a modified telemedicine protocol for abortion was found to be as effective as standard care in terms of safety, adherence, and acceptance, demonstrating increased access to safe abortion in low-resource settings.
Article
Medicine, General & Internal
Ye Lu, Ruide Su, Ruixin Chen, Wenrong Wang, Jian An
Summary: This study aimed to evaluate clinical predictors associated with complete miscarriage after medical treatment for early pregnancy loss in women with previous cesarean section. It found that blood flow signal and residual width were independent predictors for complete miscarriage. Based on these predictors, patients were divided into high, intermediate, and low probability groups, leading to different treatment recommendations.
Article
Health Care Sciences & Services
Huiliao He, Ruixing Liu, Xiuping Zhou, Yinhong Zhang, Beibei Yu, Zhihua Xu, Hu Huang
Summary: This paper discusses the diagnostic value of abdominal B-ultrasound images for intrauterine pregnancy tissue residues and proposes a CNN model optimization method based on deep learning. The results show that this method has a high accuracy in classifying abdominal B-ultrasound images of intrauterine pregnancy tissue residues.
JOURNAL OF HEALTHCARE ENGINEERING
(2022)
Article
Public, Environmental & Occupational Health
Amy Grossman, Ndola Prata, Natalie Williams, Bela Ganatra, Antonella Lavelanet, Laurence Laeser, Chilanga Asmani, Hayfa Elamin, Leopold Ouedraogo, Md. Mahmudur Rahman, Musu Julie Conneh-Duworko, Bentoe Zoogley Tehoungue, Harriet Chanza, Henry Phiri, Bharat Bhattarai, Narayan Prasad Dhakal, Olumuyiwa Adesanya Ojo, Kayode Afolabi, Theopista John Kabuteni, Binyam Getachew Hailu, Francis Moses, Sithembile Dlamini-Nqeketo, Thembi Zulu, Ulrika Rehnstroem Loi
Summary: In recent years, there has been an increase in the availability of medical abortion products in country markets and health systems. Factors such as pharmaceutical regulations, abortion laws, government policies, and service delivery guidelines influence the availability and accessibility of these products. Assessments were conducted in eight countries to better understand the availability and affordability of quality-assured medical abortion products at regional and national levels.
REPRODUCTIVE HEALTH
(2023)
Article
Green & Sustainable Science & Technology
Willington Ortiz, Ulli Vilsmaier
Summary: This study explores how theoretical advances in the diffusion of grassroots innovation can contribute to understanding and supporting the diffusion of knowledge and practices from community-based initiatives. It proposes a transdisciplinary approach to diffusion that takes into consideration the multiplicity of actors, levels, and scales, as well as the different qualities/types of knowledge and practices. The application of this approach in the context of sustainable family farming innovations in Colombia illustrates the importance of diversity as a core resource in building sustainable futures.
Article
Family Studies
Kathleen Marie Beardsworth, Uma Doshi, Elizabeth Raymond, Maureen K. Baldwin
Summary: This study conducted a retrospective chart review of outpatient medical abortions at an academic medical center in Portland, Oregon, USA, finding that telemedicine medical abortion services can reduce travel time for patients. Analysis showed that patients receiving telemedicine had shorter travel distances but longer time from initial contact to medication administration.
BMJ SEXUAL & REPRODUCTIVE HEALTH
(2022)
Review
Obstetrics & Gynecology
Eli Y. Adashi, Rohit S. Rajan, Daniel P. O'Mahony, I. Glenn Cohen
Summary: Congressional and presidential records indicate a consistent pattern of political interference with the FDA's regulatory authority over mifepristone. This article examines the ongoing legislative and legal disputes surrounding mifepristone, which comes just after its 20th anniversary of FDA approval for medical termination of intrauterine pregnancy.
Article
Obstetrics & Gynecology
Shandhini Raidoo, Bliss Kaneshiro, Paris Stowers
Summary: Despite the constitutional right to legal abortion, residents of Guam, an unincorporated territory of the United States, do not have local access to abortion services. Telehealth could potentially address this issue, but current abortion restrictions and Risk Evaluation and Mitigation Strategy requirements impede the provision of medication abortion through telehealth.
Article
Obstetrics & Gynecology
Jaclyn J. Serpico
Summary: This paper explores the excessive regulation of mifepristone and how REMS requirements manifest abortion exceptionalism. It also highlights the unnecessary nature of the mifepristone REMS and the influence of political concerns on regulatory decisions.
Article
Health Care Sciences & Services
Regina M. M. Renner, Madeleine Ennis, Ama Kyeremeh, Wendy V. V. Norman, Sheila Dunn, Helen Pymar, Edith Guilbert
Summary: A survey conducted in Canada found that less than half of the respondents reported using telemedicine for certain aspects of first-trimester medical abortion in 2019, and the majority perceived barriers.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Primary Health Care
Regina -Maria Renner, Vivien Hu, Edith R. Guilbert, Arianne Y. K. Albert, Katharine O'Connell White, Heidi E. Jones, Xiaoning Guan, Wendy Norman
Summary: This study aimed to evaluate the practices and characteristics of first-trimester surgical abortion facilities and providers in Canada in 2012. The results showed that the practices in Canada mostly followed evidence-based guidelines and the majority of providers were female family doctors. The procedures and care before and after the surgery were consistent among facilities and physicians.
CANADIAN FAMILY PHYSICIAN
(2023)
Article
Nursing
Andrea Carson, Emma Stirling Cameron, Martha Paynter, Wendy Norman, Sarah Munro, Ruth Martin-Misener
Summary: This study explores the experiences of nurse practitioners in implementing medication abortion in Canada and identifies ways to further support their implementation. The findings indicate that nurse practitioners engage in educational, communication, and networking activities, while facing resistance from employers, colleagues, and funders. The study highlights the importance of integrating abortion services in primary care and making them more accessible to patients.
JOURNAL OF ADVANCED NURSING
(2023)
Article
Family Studies
Pip Louise Maria Buckingham, Safeera Hussainy, Judith Soon, Wendy Norman, Deborah Bateson, Danielle Mazza
Summary: This study investigated the knowledge, attitudes, practices, barriers, and benefits of contraceptive care provided by community pharmacists in Australia. The results revealed that pharmacists recognized the importance of contraceptive counseling but lacked necessary resources and support to deliver consistent quality care. The study suggests exploring payment mechanisms, training opportunities, and pharmacy-specific resources to ensure high-quality person-centered care.
BMJ SEXUAL & REPRODUCTIVE HEALTH
(2023)
Article
Health Care Sciences & Services
Salima Meherali, Sarah Munro, Giulia Puinean, Bukola Salami, Josephine Pui-Hing Wong, Ashley Vandermorris, James Russell Andrew Benoit, Sarah Flicker, Philomina Okeke-Ihejirika, Eleni Stroulia, Wendy Norman, Shannon D. Scott
Summary: This study aims to develop an interactive mobile app to provide accurate and evidence-based sexual and reproductive health (SRH) information to immigrant adolescents. The research will use community-based participatory action research methods to understand the SRH needs and priorities of adolescents and engage them in designing and testing the mobile app. This study will address the knowledge gap on SRH information needs of immigrant adolescents and propose innovative strategies to improve their sexual and reproductive health.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Public, Environmental & Occupational Health
Mridula Shankar, Leesa Hooker, Kristina Edvardsson, Wendy Norman, Angela J. Taft
Summary: The aim of this study is to estimate the prevalence of unintended pregnancy and associated factors among young Australian women. The research found that unintended pregnancy among young Australian women is mainly experienced by those with structural disadvantages and exposure to sexual coercion. Therefore, service improvements should be made to achieve equitable distribution of contraception and abortion services, along with initiatives responding to sexual coercion.
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
(2023)
Article
Obstetrics & Gynecology
Madeleine Ennis, Regina M. Renner, Bimbola Olure, Wendy Norman, Stephanie Begun, Lisa Martin, Lisa H. Harris, Lauren Kean, Meghan Seewald, Sarah Munro
Summary: This study surveyed physicians, nurse practitioners, and administrators in Canada who provide abortion services to assess their experiences of stigma and harassment. The results showed that low-volume clinicians experienced less harassment compared to higher volume clinicians and administrators. Canadian abortion care providers expressed concerns about stigma interfering with their provision of abortion services and called for further destigmatization and protection through policy and practice interventions.
Article
Medicine, General & Internal
Sarah Munro, Giuseppina Di Meglio, Aleyah Williams, Skye Pamela Barbic, Stephanie Begun, Amanda Black, Andrea Carson, Michelle Fortin, Kaiya Jacob, Zeba Khan, Ruth Martin-Misener, Salima Meherali, Victoria Paller, Hajar Seiyad, Carol-Anne Vallee, Kate Wahl, Wendy Norman
Summary: This study aims to identify the barriers that youth face when accessing contraception in Canada, from the perspectives of both youth and youth service providers. It will use a prospective, mixed-methods, integrated knowledge mobilisation approach, involving in-depth interviews with youth and service providers. The study will also focus on co-creating and evaluating knowledge translation products with youth, service providers, and policy makers.
Article
Pharmacology & Pharmacy
Enav Z. Zusman, Sarah Munro, Wendy V. Norman, Judith A. Soon
Summary: This study examines the experiences of Canadian community pharmacists in dispensing mifepristone directly to patients. The results indicate that most pharmacists perceive various benefits of providing mifepristone in pharmacies and encounter minimal challenges.
CANADIAN PHARMACISTS JOURNAL
(2023)
Article
Medicine, Research & Experimental
Regina M. Renner, Madeleine Ennis, Mahan Maazi, Sheila Dunn, Wendy V. Norman, Janusz Kaczorowski, Edith Guilbert
Summary: Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since the 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPS 2019 survey instrument to explore changes in the abortion provider workforce, their clinical care, as well as experiences with stigma and harassment. The survey instrument is suitable for investigating a complex multidisciplinary workforce, their care and experience with stigma on a national level, and can be adapted to other countries.
PILOT AND FEASIBILITY STUDIES
(2023)
Article
Health Care Sciences & Services
Jennifer B. Murray, Alexander Sharp, Sarah Munro, Patricia A. Janssen
Summary: This study explored the needs and preferences for prenatal education mHealth programs and examined the extent to which SmartMom met these needs. The findings revealed that reliable information, inclusive content, and SMS text messaging were valued by pregnant individuals. Participants also highlighted the importance of catering to the needs of diverse populations, such as Indigenous communities and LGBTQIA2S+ individuals.
JMIR FORMATIVE RESEARCH
(2023)
Article
Public, Environmental & Occupational Health
Tamil Kendall, Pallavi Sriram, Amrit Parmar, Wendy V. Norman
Summary: This study analyzed Canadian newspaper coverage on medication abortion and the regulatory framework for mifepristone. The findings showed a high level of support for medication abortion and the removal of regulatory barriers. Most of the coverage focused on the health aspect of medication abortion and highlighted the potential improvements in availability, accessibility, acceptability, and quality of abortion services through liberalization of the regulatory framework.
WOMENS HEALTH ISSUES
(2023)
Article
Medicine, General & Internal
Carol-Anne Vallee, Ana Clara Sosa Cazales, Brian Fitzsimmons, Wendy V. Norman
Summary: Abortion has been legal in Canada since 1969 and is provided by obstetricians, nurses, and family doctors in both rural and urban areas. The challenges for providing accessible abortion care include the need for more practitioners to reduce travel and wait times, the listing of abortion providers in a confidential directory, and improved training and distribution of services for second-trimester surgical abortion. The era of only a small number of healthcare workers providing all aspects of abortion care is over.
BRITISH COLUMBIA MEDICAL JOURNAL
(2023)