Aspiration Abortion With Immediate Intrauterine Device Insertion

Comparing Outcomes of Advanced Practice Clinicians and Physicians

Eva Patil, Blair Darney, Kaebah Orme-Evans, Ethan H. Beckley, Linn Bergander, Mark Nichols, Paula Bednarek

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Immediate postabortion intrauterine device (IUD) insertion is a safe, effective strategy to prevent subsequent unplanned pregnancy. Oregon is one of 5 US states where advanced practice clinicians perform aspiration abortions. This study compares outcomes of first-trimester aspiration abortion with immediate IUD insertion between advanced practice clinicians and physicians. Methods: We conducted a historical cohort study of first-trimester aspiration abortions with immediate IUD insertion performed at our center from 2009 to 2011. We extracted demographic and clinical data from patient charts. Immediate complications including excessive blood loss, perforation, and reaspirations were recorded at the time of procedure. We used descriptive statistics and multivariable logistic regression to test for differences in outcomes by clinician type. Results: Data were available on 669 of the 1134 combined procedures. Advanced practice clinicians performed 224 of these. There were no significant differences in immediate outcomes. The only immediate complications were reaspirations; 1.8% (4/224) in the advanced practice clinician group, and 2.0% (9/445) in the physician group (P = .83). Discussion: We found no differences in outcomes between provider type for immediate IUD insertion after first-trimester aspiration abortion. This study helps reinforce that advanced practice clinicians can provide immediate postaspiration abortion IUD insertions with similar outcomes to those of physicians. Many countries do not allow advanced practice clinicians to perform this service, but a change in policy could help address family planning provider shortages.

Original languageEnglish (US)
JournalJournal of Midwifery and Women's Health
DOIs
StateAccepted/In press - 2016

Fingerprint

Intrauterine Devices
Physicians
First Pregnancy Trimester
Unplanned Pregnancy
Aftercare
Family Planning Services
Cohort Studies
Logistic Models
Demography
Outcome Assessment (Health Care)

Keywords

  • Advanced practice clinician
  • Aspiration abortion
  • Postabortion intrauterine device

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

Cite this

Aspiration Abortion With Immediate Intrauterine Device Insertion : Comparing Outcomes of Advanced Practice Clinicians and Physicians. / Patil, Eva; Darney, Blair; Orme-Evans, Kaebah; Beckley, Ethan H.; Bergander, Linn; Nichols, Mark; Bednarek, Paula.

In: Journal of Midwifery and Women's Health, 2016.

Research output: Contribution to journalArticle

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