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CONTEXT U.S. servicewomen have a higher rate of unintended pregnancy than civilian women, yet the military does not provide or cover abortion, except in limited circumstances. Servicewomen's experiences with abortion care have received little research attention. METHODS Twenty-one in-depth interviews with servicewomen who had had an abortion during active-duty service in the prior two years were conducted between January 2015 and July 2016. Women reported on their experiences accessing abortion, as well as their knowledge and opinions of the military's abortion policy. Data were analyzed thematically using inductive and deductive codes. RESULTS In regard to their pregnancy and abortion experiences, servicewomen cited concerns about confidentiality, stigma and negative effects on their career, which prevented half of participants from seeking care from the military. Of those who visited a military treatment facility during pregnancy, some reported feeling upset or abandoned by the lack of options counseling and referral. Women reported that the military's abortion policy had negative health and emotional consequences for servicewomen, and negative financial and logistical consequences for both servicewomen and the military. Most did not have accurate knowledge of the abortion policy. Upon learning the law, the majority believed that the military should provide and cover abortion; yet, servicewomen also expressed apprehension about the military's involvement in abortion care, because of concerns about privacy and negative effects on women's careers. CONCLUSIONS Policy recommendations to better meet the needs of servicewomen include wider dissemination of the military's abortion policy, establishing abortion referral and support guidelines, and improving confidentiality in military health services. [ABSTRACT FROM AUTHOR]

Introduction Since 2011, Planned Parenthood of the Great Northwest and the Hawaiian Islands has been providing medical abortion via telemedicine at several clinics in Alaska. The purpose of this study was to evaluate providers' experiences with telemedicine provision of medical abortion in Alaska using qualitative methods. In particular, we aimed to learn more about the impacts of telemedicine on patients, staff, and clinic operations and potential lessons for other service delivery settings. Methods Between October and November 2013, eight in-depth interviews were conducted with clinic providers and staff who were involved with the provision of medical abortion using telemedicine at Planned Parenthood of the Great Northwest and the Hawaiian Islands clinics in Alaska. All interviews were digitally recorded and transcribed verbatim, and data were analysed qualitatively with inductive coding using grounded theory methods. Results Providers reported that telemedicine provision of medical abortion facilitated a more patient-centred approach to care where women were able to be seen sooner, have greater choice in abortion procedure type, and could be seen closer to their home. Providers felt that it was easy to integrate the new technology into clinic operations, and that a telemedicine visit largely required the same overall processes and clinic flow as an in-person visit, with minor additions related to technological set-up for the doctor interface. Discussion These findings are consistent with previously published literature on medical abortion provided via telemedicine, and indicate high acceptability among providers and the appropriateness for telemedicine application to this healthcare service. [ABSTRACT FROM AUTHOR]

Abstract: Background: In states requiring physicians to dispense mifepristone, the small number of providers offering the method limits its uptake. In 2008, Planned Parenthood of the Heartland in Iowa began providing medical abortion via telemedicine at clinics without an on-site physician. The purpose of this study was to evaluate patients'' and providers'' experiences with telemedicine provision of medical abortion. Methods: Between October 2009 and February 2010, in-depth interviews were conducted at Planned Parenthood clinics with 25 women receiving medical abortion services (20 telemedicine patients and 5 in-person patients) and 15 clinic staff. Data were analyzed qualitatively for themes related to acceptability of the telemedicine service delivery model. Findings: Patients and providers cited numerous advantages of telemedicine, including decreased travel for patients and physicians and greater availability of locations and appointment times compared with in-person provision. Overall, patients were positive or indifferent about having the conversation with the doctor take place via telemedicine, with most reporting it felt private/secure and in some cases even more comfortable than an in-person visit. However, other women preferred being in the same room with the physician, highlighting the importance of informing women about their options so they can choose their preferred service modality. Conclusions: The findings from this study indicate that telemedicine can be used to provide medical abortion in a manner that is highly acceptable to patients and providers with minimal impact on the clinic. Practice Implications: This information demonstrates the feasibility of telemedicine to extend the reach of physicians and improve abortion access in rural settings. [Copyright &y& Elsevier]