Abstract
Objectives
Primary care providers are a major source of sexual and reproductive health care in
the United States, particularly in rural areas, and not all providers offer the same
services. This study aimed to understand patient preferences and expectations around
reproductive health services including abortion care in a primary care setting and
if those expectations differed by urban or rural setting.
Study Design
An anonymous survey was distributed to all patients 18 years or older in 4 primary
care clinics in Idaho, Washington, and Wyoming over a 2-week period. The survey asked
patients about which reproductive health services should be available in primary care.
Results
The overall response rate was 69% (745/1086). For all queried reproductive health
services except for aspiration abortion, the majority of respondents reported that
primary care clinics should have that service available. Forty-two percent of respondents
reported that aspiration abortion should be available in primary care. Overall, most
respondents reported that medication abortion (58%) and miscarriage management (65%)
should be available in primary care. More respondents in urban clinics thought IUD
services (84% vs 71%), medication abortion (74% vs 37%), and aspiration abortion (52%
vs 28%) should be accessible in primary care compared to those in rural-serving clinics.
Conclusions
This study of 4 primary care clinics in Idaho, Washington, and Wyoming, spanning urban
and rural settings, highlights that most patients desire contraception services and
miscarriage management to be available in primary care.
Implications
Increasing training may help meet patient desires for access to reproductive services
in primary care, however, further exploration of barriers to this care is warranted.
High rates of respondents desiring miscarriage management access highlights the need
to train more primary care clinicians to provide full spectrum miscarriage management
options.
Keywords
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Article info
Publication history
Published online: April 26, 2022
Accepted:
April 20,
2022
Received in revised form:
April 17,
2022
Received:
July 27,
2021
Footnotes
☆Declaration of Competing Interest: The author declares no conflict of interest
☆☆Funding: This study was supported by the Center for Reproductive Health Education in Family Medicine (RHEDI) as well as by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR002319.
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