[PPT] - BC MIFEPRISTONE PROVIDER STUDY RESULTS Presentations by the PowerPoint Presentation

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BC MIFEPRISTONE PROVIDER STUDY RESULTS

Presentations by the Contraception and Abortion Research Team

C O N T R A C E P T I O N & A B O R T I O N B C : E X P E R I E N C E G U I D I N G R E S E A R C H G U I D I N G C A R E

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SUPPORTING EQUITABLE ACCESS TO ABORTION CARE

PROBLEMS, SOLUTIONS & NEXT STEPS

Kate Wahl, MSc

P H D S T U D E N T @ K A T E J W A H L

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SPEAKER/PRESENTER DISCLOSURE

Kate Wahl & Laura Schummers I declare I have no relationship with commercial interests.

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ACKNOWLEDGEMENTS

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THE CART-MIFE STUDY

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WHAT MAKES MIFEPRISTONE DIFFICULT TO PROVIDE?

Federal restrictions Structural barriers Rapidly changing regulations

Apr 2017 – Dec 2018

Munro S et al. Factors influencing implementation of

mifepristone. Ann. Fam. Med. In press. 2020.

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WHAT DID CART & COLLABORATORS DO TO ADDRESS BARRIERS TO CARE? “I think there’s been a lot of design going into making that a safe space … It’s a nice centralized way

f getting

information”

021_Phys

Munro S et al. Factors influencing implementation of

mifepristone. Ann. Fam. Med. In press. 2020.

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602

2018

942

2019

1126

2020

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WHAT CAN WE STILL DO TO ADVANCE EQUITABLE ACCESS TO ABORTION CARE?

What’s your story?

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CART MIFEPRISTONE OUTCOMES STUDY

EXAMINING THE EFFECT OF MIFEPRISTONE ON CANADIAN ABORTION ACCESS, OUTCOMES, AND COSTS

Laura Schummers, ScD

P O S T - D O C T O R A L F E L L O W C I H R H E A L T H S Y S T E M I M P A C T F E L L O W M I C H A E L S M I T H F O U N D A T I O N F O R H E A L T H R E S E A R C H T R A I N E E P O S T - D O C T O R A L T R A I N E E , I C E S M C M A S T E R @ D R L S C H U M M E R S

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abortion access
abortion complications
health system costs

HOW DID MIFEPRISTONE CHANGE ABORTION IN BC?

Is the unique Canadian medical abortion policy approach working?

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POLICY ANALYSIS: How do we measure a policy effect?

30% 20% 10% 5% Mifepristone introduced Mifepristone subsidized Pre-mife 2012 2017 2018 2020

Policy effect

Mife available Mife funded

Access

Travel time;

service distribution

Outcomes

Safety;

complications

Costs

Healthy

system payments

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PREGNANCY SPACING

DETERMINING THE OPTIMAL INTERPREGNANCY INTERVAL FOR HIGH-RISK POPULATIONS

Laura Schummers, ScD

P O S T - D O C T O R A L F E L L O W C I H R H E A L T H S Y S T E M I M P A C T F E L L O W M I C H A E L S M I T H F O U N D A T I O N F O R H E A L T H R E S E A R C H T R A I N E E P O S T - D O C T O R A L T R A I N E E , I C E S M C M A S T E R @ D R L S C H U M M E R S

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INTERPREGNANCY INTERVAL RECOMMENDATIONS

Recommendations: After a live birth: interval ≥24 months After a miscarriage or induced abortion: interval ≥6 months

after live birth after miscarriage after induced abortion after perinatal loss specific high-risk populations

advanced maternal age
infertility

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OPTIAL INTERPREGNANCY INTERVAL FOR WOMEN AGE ≥35?

Delivery to conception intervals shorter than 12 months :
Increased adverse fetal-infant outcomes and preterm

birth risks for women <35 and ≥35

Increased severe maternal morbidity risksonly for

women ≥35?

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INTERPREGNANCY INTERVAL AFTER A PERINATAL LOSS? Following a perinatal loss, short interpregnancy interval:

Increased spontaneous preterm birth risk
No increased adverse fetal-infant outcome risk

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INTERPREGNANCY INTERVAL FOR HIGH-RISK WOMEN?

After spontaneous preterm birth?
After ovulation stimulation therapy for

infertility?

New pregnancy spacing recommendations?

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