Introduction: Since abortion has become a focus of increased public attention, it is important to assess family physicians' attitudes and scope of training regarding this outpatient procedure.
Methods: Residents and faculty at eight southern California family practice residency programs were surveyed about their views on first-trimester abortion, and about their interest in training to perform the procedure.
Results: While 62.5% of respondents believed abortion to be an appropriate procedure for family physicians to perform, only 19.5% had performed an abortion during the past year. Attitudes about situations in which abortion should be available to women were not associated with age, gender, or ethnicity. Religion of the respondents, however, was significantly associated with attitudes toward abortion. Of respondents without personal objections to the procedure, those who perceived the performance of abortion as appropriate for family physicians were significantly more likely to be interested in further training (48.2%) than those who did not perceive it as appropriate (18.2%, P = .0147). This perception of appropriateness was affected by whether or not a respondent had been offered training; those who had been offered training in abortion were 8.5 times more likely to believe it to be an appropriate procedure for family physicians to perform (P = .0001).
Conclusion: If the number of family physicians providing abortions is to be increased, residency programs must offer abortion training as a more fully recognized part of the family medicine curriculum.
PIP: A confidential, self-administered questionnaire was administered to 220 faculty and residents of 8 family practice residency programs in southern California to determine their attitude on 1st trimester abortion and their interest in abortion training. Age, ethnicity, and gender were not associated with abortion score. The association between religion and abortion attitudes were very significant (Out of a possible approval score of 18: Jews and those with no religious preference = about 15; Catholics, Protestants, and Buddhists = around the mean of 10.8; and those who identified themselves as Christians = 6.5) (p = 0.0001). 94.8-98.7% of respondents thought it was appropriate to perform IUD insertions, colposcopy, and endometrial biopsy, but just 62.5% thought it was appropriate to perform vacuum abortions. Faculty were more likely to believe vacuum abortions are appropriate for family physicians to perform than were residents (82.5% vs. 55.4%; p = 0.0023). Only 23.6% were interested in further training for vacuum abortions. Perception of abortion being an appropriate procedure and personal objections to performing abortions were the most significant factors linked to desire for further abortion training (34.9% for appropriate vs. 7.1% for inappropriate, p = 0.0002 and 48.2% for no personal objections vs. 18.2% for personal objections, p = 0.0147). Physicians who had been offered training in abortion were more likely to consider abortion appropriate than those who had not been offered training (85.9% vs. 41.8%; p = 0.0001; odds ratio = 8.5). These findings suggest that, to increase the numbers of family physicians willing to perform 1st trimester abortions, the number of residency programs which offer training in abortion needs to increase. The researchers conclude that training in 1st trimester abortion must be included in the standard family practice residency curriculum.