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Aspiration Abortion With Immediate Intrauterine Device Insertion: Comparing Outcomes of Advanced Practice Clinicians and Physicians
Author(s) -
Patil Eva,
Darney Blair,
OrmeEvans Kaebah,
Beckley Ethan H.,
Bergander Linn,
Nichols Mark,
Bednarek Paula H.
Publication year - 2016
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12412
Subject(s) - intrauterine device , medicine , abortion , medical emergency , family medicine , obstetrics , family planning , pregnancy , population , research methodology , environmental health , biology , genetics
Immediate postabortion intrauterine device (IUD) insertion is a safe, effective strategy to prevent subsequent unplanned pregnancy. Oregon is one of 5 US states where advanced practice clinicians perform aspiration abortions. This study compares outcomes of first‐trimester aspiration abortion with immediate IUD insertion between advanced practice clinicians and physicians. Methods We conducted a historical cohort study of first‐trimester aspiration abortions with immediate IUD insertion performed at our center from 2009 to 2011. We extracted demographic and clinical data from patient charts. Immediate complications including excessive blood loss, perforation, and reaspirations were recorded at the time of procedure. We used descriptive statistics and multivariable logistic regression to test for differences in outcomes by clinician type. Results Data were available on 669 of the 1134 combined procedures. Advanced practice clinicians performed 224 of these. There were no significant differences in immediate outcomes. The only immediate complications were reaspirations; 1.8% (4/224) in the advanced practice clinician group, and 2.0% (9/445) in the physician group ( P = .83). Discussion We found no differences in outcomes between provider type for immediate IUD insertion after first‐trimester aspiration abortion. This study helps reinforce that advanced practice clinicians can provide immediate postaspiration abortion IUD insertions with similar outcomes to those of physicians. Many countries do not allow advanced practice clinicians to perform this service, but a change in policy could help address family planning provider shortages.