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    Many Rural Women Lack Access to Abortions


    Of the 707 providers who responded, only 1.2% reported that they performed first-trimester abortions. These eight providers (five men and three women) had been in practice an average of 19 years and devoted most of their practices to women's reproductive health care. Seven were family physicians or obstetrician-gynecologists, says Dobie.

    Of those who did not offer abortions, nearly 70% of the physicians in ob/gyn and family medicine practices listed community opposition as a reason, and 65% listed personal moral objections.

    Of the 459 respondents who said they would not prescribe abortion drugs, 45% cited moral objections and 20% cited inadequate training, information, or support. But a fourth of the rural physicians indicated they would consider providing medical, rather than surgical, abortions.

    "I think it's wonderful that someone has had the courage and responsiveness to examine this issue, in preparation for a time when RU-486 may become more widely available," Roger Rochat, MD, visiting professor in the department of epidemiology at Emory University's Rollins School of Public Health in Atlanta, tells WebMD.

    "But also, she's examining the generic problem of abortion services. I'm amazed that so many people think that abortion and family planning are widely available in the U.S., and yet it's very clear that people have difficulty getting access to both of them -- and with abortion, even more so," says Rochat, who was not involved in the study.

    As with midwives who perform deliveries, nurse practitioners or physician assistants should be allowed to prescribe abortion medications only if there is professional medical support, Rochat says. "There's going to be that rare event ... where you need physician backup."

    Vital Information:

    • A study in Washington state has found that few rural health care providers are providing abortions, with many citing community opposition and personal moral objection.
    • But many providers indicated they might be willing to offer the abortion pill, known as RU-486, if it is approved by the FDA.
    • Among nurse practitioner and physician assistants, who are allowed to prescribe medications in some states, there was also a clear interest in providing the abortion pill to patients.
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