{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:52:53Z","timestamp":1791330773631,"version":"4.3.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"The Canadian Institutes of Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000024","name":"CIHR","doi-asserted-by":"publisher","award":["PHE148161"],"award-info":[{"award-number":["PHE148161"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"CIHR","doi-asserted-by":"publisher","award":["CPP-329455-107837"],"award-info":[{"award-number":["CPP-329455-107837"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"The Michael Smith Foundation for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Public Health Agency of Canada Chair in Applied Public Health Research","award":["CPP-329455-107837"],"award-info":[{"award-number":["CPP-329455-107837"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 pandemic and pandemic response created novel challenges for abortion services. Canada was uniquely positioned to transition to telemedicine because internationally common restrictions on abortion medication were removed before the pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We sought to characterize the experiences of abortion health care professionals in Canada during the COVID-19 pandemic and the impact of the pandemic response on abortion services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a sequential mixed methods study between July 2020 and January 2021. We invited physicians, nurse practitioners and administrators to participate in a cross-sectional survey containing an open-ended question about the impact of the pandemic response on abortion care. We employed an inductive codebook thematic analysis, which informed the development of a second, primarily quantitative survey.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our initial survey had 307 respondents and our second had 78. Fifty-three percent were family physicians. Our first survey found respondents considered abortion access essential. We identified three key topicss: access to abortion care was often maintained despite pandemic-related challenges (e.g. difficulty obtaining tests, additional costs); change of practice to low-touch medication abortion care and provider perceptions of patient experience, including shifting demand, telemedicine acceptability and increased rural access. The second survey indicated uptake of telemedicine medication abortion among 89% of participants except in Quebec, where regulations meant procedures were nearly exclusively surgical. Restrictions did not delay care according to 76% of participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Canadian health care professionals report their facilities deemed abortion an essential service. Provinces and territories, except Quebec, described a robust pandemic transition to telemedicine to ensure access to services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Podcast<\/jats:title>\n                  <jats:p>An accompanying podcast is available in the Supplementary Data, in which the authors Dr Madeleine Ennis and Kate Wahl discuss their research on how family planning care and access to abortion services have changed during the COVID-19 pandemic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmab083","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T19:13:27Z","timestamp":1624562007000},"page":"i30-i36","source":"Crossref","is-referenced-by-count":24,"title":["The perspective of Canadian health care professionals on abortion service during the COVID-19 pandemic"],"prefix":"10.1093","volume":"38","author":[{"given":"Madeleine","family":"Ennis","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wahl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahn","family":"Jeong","sequence":"additional","affiliation":[{"name":"The School of Population and Public Health, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Family Practice, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Renner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Munro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Guilbert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Laval University, Quebec City, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-7882","authenticated-orcid":false,"given":"Wendy V","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Family Practice, University of British Columbia, Vancouver, Canada"},{"name":"Department of Public Health, Environments and Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"issue":"4","key":"2021082709443264400_CIT0001","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1136\/bmjsrh-2020-200709","article-title":"The impact of COVID-19 on contraception and abortion care policy and practice: experiences from selected countries","volume":"46","author":"Bateson","year":"2020","journal-title":"BMJ Sex Reprod Health"},{"key":"2021082709443264400_CIT0002","doi-asserted-by":"crossref","first-page":"100049","DOI":"10.1016\/j.conx.2020.100049","article-title":"Adoption of no-test and telehealth medication abortion care among independent abortion providers in response to COVID-19","volume":"2","author":"Upadhyay","year":"2020","journal-title":"Contracept X"},{"key":"2021082709443264400_CIT0003","doi-asserted-by":"crossref","first-page":"bmjsrh-2020-200880","DOI":"10.1136\/bmjsrh-2020-200880","article-title":"Demand for self-managed online telemedicine abortion in eight European countries during the COVID-19 pandemic: a regression discontinuity analysis","author":"Aiken","year":"2021","journal-title":"BMJ Sex Reprod Health"},{"issue":"1","key":"2021082709443264400_CIT0004","doi-asserted-by":"crossref","first-page":"lsaa013","DOI":"10.1093\/jlb\/lsaa013","article-title":"The legal and medical necessity of abortion care amid the COVID-19 pandemic","volume":"7","author":"Donley","year":"2020","journal-title":"J Law Biosci"},{"key":"2021082709443264400_CIT0005","doi-asserted-by":"crossref","first-page":"bmjsrh-2020-200724","DOI":"10.1136\/bmjsrh-2020-200724","article-title":"Abortion regulation in Europe in the era of COVID-19: a spectrum of policy responses","author":"Moreau","year":"2020","journal-title":"BMJ Sex Reprod Health"},{"key":"2021082709443264400_CIT0006","volume-title":"Coronavirus (COVID-19) Infection and Abortion Care: Information for Healthcare Professionals (Version 3.1)","author":"RCOG","year":"2020"},{"key":"2021082709443264400_CIT0007","volume-title":"Prise en charge des IVG m\u00e9dicamenteuses hors \u00e9tablissements hospitaliers durant l\u2019\u00e9tat d\u2019urgence de l\u2019\u00e9pid\u00e9mie de COVID et R\u00e8gles de facturarion","author":"CNGOF","year":"2020"},{"key":"2021082709443264400_CIT0008","volume-title":"COVID-19: Access to Reproductive Health Services","author":"RANZCOG","year":"2020"},{"key":"2021082709443264400_CIT0009","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.bpobgyn.2019.05.010","article-title":"When there are no abortion laws: a case study of Canada","volume":"62","author":"Shaw","year":"2020","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"5","key":"2021082709443264400_CIT0010","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1370\/afm.2562","article-title":"Perspectives among Canadian physicians on factors influencing implementation of mifepristone medical abortion: a national qualitative study","volume":"18","author":"Munro","year":"2020","journal-title":"Ann Fam Med"},{"key":"2021082709443264400_CIT0011","author":"Health Canada","year":"2019"},{"key":"2021082709443264400_CIT0012","author":"Costescu","year":"2020"},{"key":"2021082709443264400_CIT0013","author":"Guilbert","year":"2020"},{"issue":"5","key":"2021082709443264400_CIT0014","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.jogc.2020.02.050","article-title":"Explaining slow implementation of mifepristone in Quebec with the transtheoretical model of change","volume":"42","author":"Guilbert","year":"2020","journal-title":"J Obstet Gynaecol Can"},{"issue":"5","key":"2021082709443264400_CIT0015","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jogc.2019.10.037","article-title":"Barriers and facilitators to the implementation of first trimester medical abortion with mifepristone in the province of Qu\u00e9bec: a qualitative investigation","volume":"42","author":"Wagner","year":"2020","journal-title":"J Obstet Gynaecol Can"},{"key":"2021082709443264400_CIT0016","doi-asserted-by":"crossref","DOI":"10.1111\/1471-0528.16668","article-title":"Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine: a national cohort study","author":"Aiken","year":"2021","journal-title":"BJOG"},{"issue":"12","key":"2021082709443264400_CIT0017","doi-asserted-by":"crossref","first-page":"e003934","DOI":"10.1136\/bmjgh-2020-003934","article-title":"Effectiveness, safety and acceptability of medical abortion at home versus in the clinic: a systematic review and meta-analysis in response to COVID-19","volume":"5","author":"Gambir","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2021082709443264400_CIT0018","doi-asserted-by":"crossref","first-page":"bmjsrh-2020-200976","DOI":"10.1136\/bmjsrh-2020-200976","article-title":"Telemedicine medical abortion at home under 12 weeks\u2019 gestation: a prospective observational cohort study during the COVID-19 pandemic","author":"Reynolds-Wright","year":"2021","journal-title":"BMJ Sex Reprod Health"},{"issue":"5","key":"2021082709443264400_CIT0019","doi-asserted-by":"crossref","first-page":"102038","DOI":"10.1016\/j.jogoh.2020.102038","article-title":"COVID-19 impact in abortions\u2019 practice, a regional French evaluation","volume":"50","author":"Gibelin","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"2021082709443264400_CIT0020","doi-asserted-by":"crossref","first-page":"bmjsrh-2020-200954","DOI":"10.1136\/bmjsrh-2020-200954","article-title":"Acceptability of no-test medical abortion provided via telemedicine during Covid-19: analysis of patient-reported outcomes","author":"Porter Erlank","year":"2021","journal-title":"BMJ Sex Reprod Health"},{"issue":"5","key":"2021082709443264400_CIT0021","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.jogc.2020.02.095","article-title":"Development and testing for a national survey: the Canadian Abortion Provider Survey (CAPS)","volume":"42","author":"Renner","year":"2020","journal-title":"J Obstet Gynaecol Can"},{"issue":"9","key":"2021082709443264400_CIT0022","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"key":"2021082709443264400_CIT0023","volume-title":"Mail and Internet Surveys: The Tailored Design Method","author":"Dillman","year":"2000"},{"key":"2021082709443264400_CIT0024","first-page":"1","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","author":"Braun","year":"2020","journal-title":"Qual Res Psychol"},{"key":"2021082709443264400_CIT0025","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1080\/13625187.2020.1743825","article-title":"Slow implementation of mifepristone medical termination of pregnancy in Quebec, Canada: a qualitative investigation","volume":"25","author":"Guilbert","year":"2020","journal-title":"Eur J Contracept Reprod Health Care"},{"issue":"4","key":"2021082709443264400_CIT0026","doi-asserted-by":"crossref","first-page":"e028443","DOI":"10.1136\/bmjopen-2018-028443","article-title":"Could implementation of mifepristone address Canada\u2019s urban-rural abortion access disparity: a mixed-methods implementation study protocol","volume":"9","author":"Norman","year":"2019","journal-title":"BMJ Open"},{"issue":"4","key":"2021082709443264400_CIT0027","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1363\/psrh.12163","article-title":"COVID-19 and independent abortion providers: findings from a rapid-response survey","volume":"52","author":"Roberts","year":"2020","journal-title":"Perspect Sex Reprod Health"},{"issue":"4","key":"2021082709443264400_CIT0028","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1097\/AOG.0000000000004081","article-title":"Demand for self-managed online telemedicine abortion in the United States during the Coronavirus disease 2019 (COVID-19) pandemic","volume":"136","author":"Aiken","year":"2020","journal-title":"Obstet Gynecol"},{"key":"2021082709443264400_CIT0029","doi-asserted-by":"crossref","first-page":"105","DOI":"10.7326\/M20-6671","article-title":"Ensuring safe access to mifepristone during the pandemic and beyond","volume":"174","author":"Brown","year":"2020","journal-title":"Ann Intern Med"},{"key":"2021082709443264400_CIT0030","author":"Health Canada"},{"key":"2021082709443264400_CIT0031","author":"Canadian Pharmacists Association","year":"2020"}],"container-title":["Family Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/fampra\/article-pdf\/38\/Supplement_1\/i30\/40037454\/cmab083.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/fampra\/article-pdf\/38\/Supplement_1\/i30\/40037454\/cmab083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T09:47:59Z","timestamp":1630057679000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/fampra\/article\/38\/Supplement_1\/i30\/6358430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,23]]},"references-count":31,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2021,8,23]]},"published-print":{"date-parts":[[2021,8,27]]}},"URL":"https:\/\/doi.org\/10.1093\/fampra\/cmab083","relation":{},"ISSN":["1460-2229"],"issn-type":[{"value":"1460-2229","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,9,1]]},"published":{"date-parts":[[2021,8,23]]}}}