Are US health professionals likely to prescribe mifepristone or methotrexate?

Abstract

Objective: To determine US health professionals' knowledge, attitudes, and practices regarding mifepristone and methotrexate as abortifacients.

Methods: In 1997, we conducted a nationally representative telephone survey of US obstetrician/gynecologists (OBs), family practice physicians (FPs), nurse practitioners (NPs), and physician assistants (PAs).

Results: Most health professionals surveyed considered themselves at least "somewhat familiar" with mifepristone or methotrexate, but few reported being "very familiar" with the methods. OBs were most likely to report being familiar with mifepristone (79%), followed by NPs/PAs (73%), and FPs (62%). FPs and NPs/PAs reported being less familiar with methotrexate than with mifepristone. If mifepristone were approved by the Food Drug Administration (FDA), 54% of OBs said they would be "very" or "somewhat" likely to prescribe the drug for abortion, including 35% of OBs who do not perform surgical abortions currently. About half of FPs and NPs/PAs were interested in offering mifepristone if approved by the FDA. Few health professionals reported ever having prescribed methotrexate for abortion.

Conclusion: The providers most likely to express interest in offering medical alternatives were OBs who reported they "ever perform surgical abortions." Many health professionals who said they do not perform surgical abortions also said they would be interested in prescribing mifepristone, indicating a potential expansion of the number of health professionals who will provide abortion services. Medical protocol and legal issues may inhibit or slow expansion of the pool of providers offering medical abortion.