Grant: Project Grant

Access to abortion is inequitable in Canada. Most abortions are provided using surgery and are available only in large cities. Those living in rural and remote communities face particular difficulties to accessing abortion care. In 2017, Canada introduced mifepristone, a drug used for medical abortion. Because of Canada's unique mifepristone policies, this form of abortion could be available in primary care settings, which may improve abortion access in Canada through delivery closer- to-home. However, the actual impact of mifepristone introduction on abortion access, outcomes, and costs in Canada is not yet known. Also, countries around the world seek to understand the effects of Canada's unique deregulation of medical abortion. In this study, we will measure the impact of mifepristone introduction on abortion access, outcomes, and costs using Canada's comprehensive health administrative data. Research question: How has mifepristone medical abortion affected abortion access and service distribution, adverse event rates, and health system costs in Canada? Methods: This study uses linked population-based health administrative data to examine abortion outcomes, access, and costs for abortions before and after mifepristone introduction, in British Columbia and Ontario. Our team has conducted foundational mifepristone implementation research engaging health policy, system, service decision makers as well as health professionals. Federal and provincial health policymakers and system leaders are integrated into our research team to facilitate timely improvements. This study builds on our prior work which supports integrated knowledge translation of the results. Impact: This will be the first comprehensive examination of abortion services in Canada following mifepristone introduction, and will enable health policy, system and service delivery decision makers to further equitable access to safe, effective abortion care for patients across Canada and around the world.