When Abortion is Not Available: Abortion is Essential Healthcare – Ryan Curriculum

Presented by Ana Delgado, CNM (she/her)

Citations

  1. National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. https://doi.org/10.17226/24950.
  2. Abortion training and education. Committee Opinion No. 612. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124:1055–9. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/11/abortion-training-and-education
  3. ACGME Clarification on Requirements Regarding Family Planning and Contraception. Accreditation Council for Graduate Medical Education, 2017.http://www.acgme.org/portals/0/pfassets/programresources/220_obgyn_abortion_training_clarification.pdf

Uterine Aspiration Abortion – Ryan Curriculum

Presented by: Sanithia L. Williams, MD
University of California, San Francisco

Citations

When Abortion is Not Available: Abortion is Essential Healthcare

Presented by Ana Delgado, CNM (she/her)

Supplemental Video Content

EXPLAINED: Abortion Safety in the United States Lecture
EXPLAINED: Targeted Regulation of Abortion Providers Lecture

Resources

Safe abortion: technical and policy guidance for health systems

ACOG Committee Opinion 612

ACGME Clarification on Requirements Regarding Family Planning

The International Federation of Gynecology and Obstetrics

World Health Organization

Citations

  1. National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. https://doi.org/10.17226/24950.
  2. Abortion training and education. Committee Opinion No. 612. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124:1055–9. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/11/abortion-training-and-education
  3. ACGME Clarification on Requirements Regarding Family Planning and Contraception. Accreditation Council for Graduate Medical Education, 2017. http://www.acgme.org/portals/0/pfassets/programresources/220_obgyn_abortion_training_clarification.pdf

When Abortion is Not Available: Caring for Patients After Self-management of Abortion

Presented by Biftu Mengesha, MD, MAS (she/her)

Supplemental Video Content

Early Pregnancy Loss: Diagnosis and Evaluation

Early Pregnancy Loss: At-home-management

Early Pregnancy Loss: Medication Management

Medication Abortion

Resources

 If/When/How

Self-Managed Abortion- What Healthcare Workers Need to Know. Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health

Perspectives on self-managed abortion among providers in hospitals along the Texas–Mexico border

Citations

  1. Conti J, Cahill EP. Self-managed abortion. Curr Opin Obstet Gynecol. 2019 Dec;31(6):435-440.
  2. If When How Lawyering for Reproductive Justice. “Self-Managed Abortion, the Law, and COVID-19 Fact Sheet.” https://www.ifwhenhow.org/wp-content/uploads/2020/04/20_04_Final_SMA_TheLaw_COVID-19_FactSheet_PDF.pdf
  3. Center for Reproductive Rights. “Medical Abortion and Self-Managed Abortion: Frequently Asked Questions on Health and Human Rights.” Dec 2020. https://reproductiverights.org/document/medical-abortion-self-managed-abortion-faq
  4. Donovan MK. Self-Managed Medication Abortion: Expanding the Available Options for US Abortion Care. Guttmacher Institute. Volume 21. Oct 2018.
  5. Rowan A. Prosecuting Women for Self-Inducing Abortion: Counterproductive and Lacking Compassion. Guttmacher Institute. Volume 18, Issue 3. Sept 2015.

When Abortion is Not Available: Self-management of Abortion

Presented by Bhavik Kumar, MD, MPH (he/him)

Supplemental Video Content

Global Obstacles to Abortion

Guidelines for Safe Abortion Care

EXPLAINED: Abortion Safety in the United States Lecture

Additional Resources

Access, Delivered: A Toolkit for Providers Offering Medication Abortion

Misoprostol-Only Medication Abortion Sample Protocol

IPAS Abortion Self-Care

IPAS Medical Abortion and Self-Managed Abortion Human Rights

Eukiapp

Women Help Women

Women on Web

American Bar Association’s resolution opposes criminalization of abortion or miscarriage

Citations

  1. An Overview of Abortion Laws. Guttmacher 2020. https://www.guttmacher.org/state-policy/explore/overview-abortion-laws#
  2. Singh S, Remez L, Sedgh G, Kwok L, Onda T. Abortion Worldwide 2017: Uneven Progress and Unequal Access. Guttmacher 2018. https://www.guttmacher.org/report/abortion-worldwide-2017
  3. Donovan Self-Managed Medication Abortion: Expanding the Available Options for U.S. Abortion Care. Guttmacher 2018; 21.
  4. Jones R, Donovan M. Self-managed abortion may be on the rise, but probably not a significant driver of the overall decline in abortion. Guttmacher 2019. https://www.guttmacher.org/article/2019/11/self-managed-abortion-may-be-rise-probably-not-significant-driver-overall-decline
  5. Self-Managed Abortion- What Healthcare Workers Need to Know. Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health.
  6. Baker C. Self-Managed Abortion Is Medically Very Safe. But Is It Legally Safe? MS Magazine 2020. https://msmagazine.com/2020/04/01/self-managed-abortion-is-medically-very-safe-but-is-it-legally-safe/
  7. Worldwide, an Estimated 25 Million Unsafe Abortions Occur Each Year. Guttmacher and WHO News Release, 2017. https://www.guttmacher.org/news-release/2017/worldwide-estimated-25-million-unsafe-abortions-occur-each-year
  8. Harris L, Grossman D. Complications of Unsafe and Self-Managed Abortion. N Engl J Med 2020; 382:1029-1040 https://pubmed.ncbi.nlm.nih.gov/32160664/
  9. Statement on Decriminalization of Self-Induced Abortion. ACOG 2017. https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2017/decriminalization-of-self-induced-abortion
  10. Fulfilling Roe’s Promise: 2019 Update. If/When/How 2019. https://www.ifwhenhow.org/resources/roes-unfinished-promise-2019-update/
  11. When Self-Abortion is a Crime. National Institute for Reproductive Health 2017. https://www.nirhealth.org/decriminalize/
  12. World Health Organization. (2012) Safe abortion: technical and policy guidance for health systems – 2nd ed. https://apps.who.int/iris/bitstream/handle/10665/70914/9789241548434_eng.pdf?sequence=1

Complications of Procedural Abortion & Prevention Strategies

Presented by Lara Crystal-Ornelas, MD (she/her/ella)
University of California, San Francisco

Citations

  • Allen Contraception 2007
  • Autry et al. AJOG 2002
  • Bartz et al. Obstetrics and Gynecology 2013
  • Ben-Ami et al. AJOG 2009
  • Darney, Phillip D., and Richard L. Sweet. “Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation.” Journal of ultrasound in medicine 8.2 (1989): 71-75.
  • Fakih et al. Contraception 1986
  • Frick et al. Obstet Gynecol 2012
  • Hakim-Elahi et al. Obstet Gynecol 1990
  • Hern et al. Obstet Gynecol 1984
  • Kapp Cochrane Syst Database Rev 2010
  • Kapp et al. Contraception 2012
  • Nichols et al. J Reprod Med 2002;
  • Paul et al. NAF Textbook 2009
  • Peterson et al. Obstet Gynecol 1983
  • Serapio ET, Pearlson GA, Drey EA, Kerns JL. Estimated versus measured blood loss during dilation and evacuation: an observational study. Contraception. 2018 May;97(5):451-455. doi: 10.1016/j.contraception.2018.01.008. Epub 2018 Feb 2. PMID: 29410259.

When Abortion is Not Available: Healthcare Provider Responsibilities

Presented by Teresa DePiñeres, MD, MPH, FACOG (she/her/ella)

Supplemental Video Content

Physicians Professional Responsibility in Abortion Care

Abortion in Primary Care

The Role of Nurses in Abortion Care

EXPLAINED Turnaway Study Lecture

Resources

Beyond do No Harm: 13 Principles for Health Care Providers to Interrupt Criminalization

Misoprostol-Only Medication Abortion Sample Protocol

National Network of Abortion Funds

NAF hotline

PROVIDE Abortion Referral Tool

Abortion Care Network Clinic finder

National Advocates for Pregnant Women

PLAN C – A safe self-managed abortion

Citations

  1. The United Nations The Universal Declaration of Human Rights
  2. The World Health Organization Constitution
  3. Statement on Decriminalization of Self-Induced Abortion. ACOG 2017.

Managing Complications of Procedural Abortion

Presented by Josephine Urbina, MD (she/her/ella)
University of California, San Francisco

Citations

  • Society of Family Planning, Management of Postabortion Hemorrhage, Contraception 2013
  • Society ofFamily Planning, Management of Postabortion Hemorrhage, Contraception 2013
  • Zane S, Creanga AA, Berg CJ, Pazol K, Suchdev DB, Jamieson DJ, Callaghan WM. Abortion-Related Mortality in the United States: 1998-2010. Obstet Gynecol. 2015 Aug;126(2):258-265. doi: 10.1097/AOG.0000000000000945. PMID: 26241413; PMCID: PMC4554338.
  • Peterson WF, Berry FN, Grace MR, Gulbranson CL. Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. Obstet Gynecol. 1983 Aug;62(2):185-90. PMID: 6866362.
  • Fox MC, Hayes JL; Society of Family Planning. Cervical preparation for second-trimester surgical abortion prior to 20 weeks of gestation. Contraception. 2007 Dec;76(6):486-95. doi: 10.1016/j.contraception.2007.09.004. Epub 2007 Nov 9. PMID: 18061709.
  • Diedrich J, Steinauer J. Complications of surgical abortion. Clin Obstet Gynecol. 2009 Jun;52(2):205-12. doi: 10.1097/GRF.0b013e3181a2b756. PMID: 19407527.
  • Bartlett LA, Berg CJ, Shulman HB, Zane SB, Green CA, Whitehead S, Atrash HK. Risk factors for legal induced abortion-related mortality in the United States. Obstet Gynecol. 2004 Apr;103(4):729-37. doi: 10.1097/01.AOG.0000116260.81570.60. PMID: 15051566.
  • Kerns JL, Ti A, Aksel S, Lederle L, Sokoloff A, Steinauer J. Disseminated Intravascular Coagulation and Hemorrhage After Dilation and Evacuation Abortion for Fetal Death. Obstet Gynecol. 2019 Oct;134(4):708-713. doi: 10.1097/AOG.0000000000003460. PMID: 31503145.
  • Kerns J, Steinauer J. Management of postabortion hemorrhage: release date November 2012 SFP Guideline #20131. Contraception. 2013 Mar;87(3):331-42. doi: 10.1016/j.contraception.2012.10.024. Epub 2012 Dec 4. PMID: 23218863.
  • Newmann S, Dalve-Endres A, Drey EA; Society of Family Planning. Clinical guidelines. Cervical preparation for surgical abortion from 20 to 24 weeks’ gestation. Contraception. 2008 Apr;77(4):308-14. doi: 10.1016/j.contraception.2008.01.004. Epub 2008 Mar 4. PMID: 18342657.
  • Shaw KA, Lerma K. Update on second-trimester surgical abortion. Curr Opin Obstet Gynecol. 2016 Dec;28(6):510-516. doi: 10.1097/GCO.0000000000000318. PMID: 27684047.
  • Shaw KA, Lerma K, Shaw JG, Scrivner KJ, Hugin M, Hopkins FW, Blumenthal PD. Preoperative effects of mifepristone for dilation and evacuation after 19 weeks of gestation: a randomised controlled trial. BJOG. 2017 Dec;124(13):1973-1981. doi: 10.1111/1471-0528.14900. Epub 2017 Sep 27. PMID: 28834186.
  • Borgatta L, Roncari D, Sonalkar S, Mark A, Hou MY, Finneseth M, Vragovic O. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception. 2012 Nov;86(5):567-71. doi: 10.1016/j.contraception.2012.05.002. Epub 2012 Jun 6. PMID: 22682721.
  • Darney PD, Sweet RL. Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation. J Ultrasound Med. 1989 Feb;8(2):71-5. doi: 10.7863/jum.1989.8.2.71. PMID: 2651693.
  • Pridmore BR, Chambers DG. Uterine perforation during surgical abortion: a review of diagnosis, management and prevention. Aust N Z J Obstet Gynaecol. 1999 Aug;39(3):349-53. doi: 10.1111/j.1479-828x.1999.tb03413.x. PMID: 10554950.
  • Sawaya GF, Grady D, Kerlikowske K, Grimes DA. Antibiotics at the time of induced abortion: the case for universal prophylaxis based on a meta-analysis. Obstet Gynecol. 1996 May;87(5 Pt 2):884-90. PMID: 8677129.
  • Whitehouse K, Tschann M, Soon R, Davis J, Micks E, Salcedo J, Savala M, Kaneshiro B. Effects of Prophylactic Oxytocin on Bleeding Outcomes in Women Undergoing Dilation and Evacuation: A Randomized Controlled Trial. Obstet Gynecol. 2019 Mar;133(3):484-491. doi: 10.1097/AOG.0000000000003104. Erratum in: Obstet Gynecol. 2019 Jun;133(6):1287-1288. PMID: 30741801.
  • Kerns JL, Pearlson G, Mengesha B, Harter K, Jackson RA, Drey EA. A randomized controlled trial of methylergonovine prophylaxis after dilation and evacuation abortion. Contraception. 2021 Feb;103(2):116-120. doi: 10.1016/j.contraception.2020.10.009. Epub 2020 Oct 17. PMID: 33075332.
  • Steinauer JE, Diedrich JT, Wilson MW, Darney PD, Vargas JE, Drey EA. Uterine artery embolization in postabortion hemorrhage. Obstet Gynecol. 2008 Apr;111(4):881-9. doi: 10.1097/AOG.0b013e3181685780. PMID: 18378747.

Physician Advocacy in Action Part 5

In this video, Dr. Mae Winchester, LTA Class of 2020,  provides advice for physicians in advocacy work and how to stay motivated. 

Winchester, M. Physician Advocacy in Action Part 5. Vimeo. https://vimeo.com/543677909. Published May 1, 2021. Accessed May 1, 2021.