“We can take care of that for you here”: Providers’ perspectives on discussing available abortion services Alyce Sutko MD MPH, Megan Hatcher-Lee MS3, Carie Cox PhD, Grace Shih, MD MAS University of Washington, Department of Family Medicine Background Most patients (73%) would prefer to have an abortion performed by their primary care provider (PCP) Non-specialized physicians’ offices (including ob-gyn, family medicine, and primary care offices) represent 17% of known abortion providers, yet only 1% of all abortions are performed in this setting. Objectives Explore providers’ practices in discussing available abortion services Explore providers’ perceived benefits and risks to discussing available abortion services Explore providers’ barriers in discussing available abortion services Methods and Study Population 7 PCPs who practice in a primary care clinic that provides abortion services in Seattle, WA Participants were interviewed one-on-one lasting approximately 30 minutes Interviews were recorded and transcribed Analysis Two investigators independently reviewed and coded transcripts with Dedoose software Coding and analysis was an iterative process and continued until thematic saturation was reached Results No providers routinely inform patients about available abortion services, but most recognize benefits in doing so. Reported benefits to discussing available abortion services include: Increasing patient awareness of abortion care in primary care clinic Increased awareness of pregnancy options Results Perceived barriers and fears regarding routine discussion of available abortion services include: Lack of time Fear of impacting patient-provider relationship Feels irrelevant Conclusions PCPs are not routinely discussing available abortion services with patients PCPs identify both benefits and risks to discussing available abortion services. PCPs have significant concerns about adequate time in clinic visits “I think that would actually be really good, because a lot of people just think [there’s] the one place you can go … but I actually haven't sold our services and said hey, if you get pregnant and you don't want to keep the pregnancy, we can take care of that for you here.” “There’s so many topics we need to go through and already I feel I’m not talking about important ones.” “A minority of people really equate abortion with first- degree murder. And I had a small number of people get furious, they would accuse me of bad things. But that's rare, that's less than 10%”. “[If] someone was coming in for a cough, that's the last thing on their mind. I think it would feel a little bit out of the blue to talk to them about their sexual history and that we have abortion care services here” Next Steps Develop and test protocols that integrate routinely discussing available abortion services “I think that is definitely something we could do to boost awareness, so including that in our regular conversation we have about birth control or pregnancy.”

Study Population Female3 Male4 Age (in years) Under Over 503 Perform Abortions Yes4 No3