Early Options: Module 5 - Medical Abortion Service Delivery

Early Options - A Provider's Guide to Medical Abortion

The on-line CME post-test will follow this module. However, we strongly urge you to print out the CME Post-Test Questions before starting this module to help guide you through the material.

Objectives
Upon completion of this module, you should be able to:
1. Describe the physical facility and clinic flow issues related to the provision of medical abortion services
2. Discuss staffing models for providing medical abortion
3. Discuss administrative and regulatory issues to address when initiating and implementing medical abortion services

Introduction
Medical abortion can be provided safely in diverse settings, ranging from freestanding clinics to hospital-based facilities to a solo practitioner's office. Prior to the approval of mifepristone by the Food and Drug Administration (FDA), the provision of medical abortion occurred mainly at facilities that also provided surgical abortion services. Now that mifepristone is available (approved in the U.S. under the brand name Mifeprex®), medical abortion can be offered in many practice settings that did not previously offer abortion services.

The extent to which this occurs will depend on many variables, including how comfortable the medical, administrative, and support staff are incorporating medical abortion into the range of services that they provide. To provide this service efficiently and effectively, practices will have to establish a delivery system that addresses the anticipated needs of patients and clinical and administrative staff.

A variety of administrative and regulatory issues may require attention, including staff training, quality assurance and quality improvement practices, adjustments to malpractice insurance policies, compliance with abortion-specific laws and regulations, and evaluation of security measures. New providers of medical abortion services may also need to rethink clinic flow issues and may subsequently make some minor modifications to the physical layout of their facilities.

The literature on administrative issues surrounding abortion care is limited. For this reason, much of the information on administrative issues presented in this module derives from the experiences of providers who have successfully incorporated medical abortion into their scope of services.

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Proceed to Note on Legal and Regulatory Issues.

References for this module