Grant: Project Grant

Nurse Practitioners are often the most trusted and sometimes the only health care professional available, and are well placed to provide essential sexual and reproductive health care services across Canada. Abortion is a common reproductive health procedure with nearly one third of females in Canada having at least one abortion. However, access is not equal while almost all Canadian abortions are performed using surgery, in fewer than 100 facilities, usually located only in our largest cities. Mifepristone, a highly effective and safe medication to induce an abortion, has been available in Canada since Jan 2017. Mifepristone has been used in more than 60 countries around the world, and has been in use since 1988. Many studies have shown that Nurse Practitioners are capable to provide high quality mifepristone medical abortion. Primary care provision of mifepristone, particularly in rural and remote communities and among disadvantaged populations, carries the potential to address current inequalities. However, as this practice is new, little is known about how to support primary care nurse practitioners to provide medical abortion. Also, no system is in place to identify and address barriers and facilitators to the implementation of high quality care for this new service. This study, beginning just as this new practice is first adopted in Canada, proposes to identify and address the factors necessary to ensure high quality, accessible provision of medical abortion services by Nurse Practitioners throughout Canada.