Abortion and human rights

Towards a better understanding of abortion misinformation in the USA: a review of the literature

Roughly 20% of women in the USA will seek an abortion during their lifetimes. As abortion is a medical procedure, individuals seeking abortion services must have access to accurate medical information. Inaccurate information about abortion, known as abortion misinformation, adversely affects knowledge about abortion, and may impair informed decision-making. Abortion misinformation has received limited attention in psychological and health research. This review summarises current findings on abortion misinformation from studies of adults in the USA, examines which forms of misinformation are most common, and assesses prominent sources of abortion misinformation. A narrative, integrative approach was adopted focussing on nine articles. Findings suggest that first, inaccurate beliefs about abortion exist among many samples of US adults, including inaccurate connections between abortion and breast cancer, infertility and negative mental health outcomes. Second, abortion misinformation comes from a variety of informational sources, which may render efforts to prevent it challenging. Summarising and extending knowledge of abortion misinformation may be useful first steps to better understanding this phenomenon and may ultimately aid in reduction of abortion misinformation among individuals living in the USA.

Assessing abortion coverage in nurse practitioner programs in Canada: a national survey of program directors

OBJECTIVES

Although nurse practitioners (NPs) play a critical role in the delivery of reproductive health services in Canada, there is a paucity of published information regarding the reproductive health education provided in their training programs. Our study aimed to understand better the didactic and curricular coverage of abortion in Canadian NP programs.

STUDY DESIGN

In 2014, we conducted a 3-contact, bilingual (English-French) mailed survey to assess the coverage of, time dedicated to and barriers to inclusion of 17 different areas of reproductive health, including abortion. We also asked respondents to speculate on whether or not mifepristone would be incorporated into the curriculum if approved by Health Canada for early abortion. We analyzed our results with descriptive statistics and used inductive techniques to analyze the open-ended questions for content and themes.

RESULTS

Sixteen of 23 (70%) program directors or their designees returned our survey. In general, abortion-related topics received less coverage than contraception, ectopic pregnancy management and miscarriage management. Fifty-six percent of respondents reported that their program did not offer information about first-trimester abortion procedures and/or post-abortion care in the didactic curriculum. Respondents expressed interest in incorporating mifepristone/misoprostol into NP education and training.

CONCLUSION

Reproductive health issues receive uneven and often inadequate curricular coverage in Canadian NP programs. Identifying avenues to expand education and training on abortion appears warranted. Embarking on curricular reform efforts is especially important given the upcoming introduction of mifepristone into the Canadian health system for early abortion.

IMPLICATIONS

Our findings draw attention to the need to integrate abortion-related content into NP education and training programs. The approval of Mifegymiso® may provide a window of opportunity to engage in curriculum reform efforts across the health professions in Canada.

Measuring unsafe abortion-related mortality: a systematic review of the existing methods

BACKGROUND

The WHO estimates that 13% of maternal mortality is due to unsafe abortion, but challenges with measurement and data quality persist. To our knowledge, no systematic assessment of the validity of studies reporting estimates of abortion-related mortality exists.

STUDY DESIGN

To be included in this study, articles had to meet the following criteria: (1) published between September 1(st), 2000-December 1(st), 2011; (2) utilized data from a country where abortion is "considered unsafe"; (3) specified and enumerated causes of maternal death including "abortion"; (4) enumerated ≥100 maternal deaths; (5) a quantitative research study; (6) published in a peer-reviewed journal.

RESULTS

7,438 articles were initially identified. Thirty-six studies were ultimately included. Overall, studies rated "Very Good" found the highest estimates of abortion related mortality (median 16%, range 1-27.4%). Studies rated "Very Poor" found the lowest overall proportion of abortion related deaths (median: 2%, range 1.3-9.4%).

CONCLUSIONS

Improvements in the quality of data collection would facilitate better understanding global abortion-related mortality. Until improved data exist, better reporting of study procedures and standardization of the definition of abortion and abortion-related mortality should be encouraged.