Physician assistants as providers of surgically induced abortion services

Abstract

Objectives: We compared complication rates after surgical abortions performed by physician assistants with rates after abortions performed by physicians.

Methods: A 2-year prospective cohort study of women undergoing surgically induced abortion was conducted. Ninety-one percent of eligible women (1363) were enrolled.

Results: Total complication rates were 22.0 per 1000 procedures (95% confidence interval [CI] = 11.9, 39.2) performed by physician assistants and 23.3 per 1000 procedures (95% CI = 14.5, 36.8) performed by physicians (P =.88). The most common complication that occurred during physician assistant-performed procedures was incomplete abortion; during physician-performed procedures the most common complication was infection not requiring hospitalization. A history of pelvic inflammatory disease was associated with an increased risk of total complications (odds ratio = 2.1; 95% CI = 1.1, 4.1).

Conclusions: Surgical abortion services provided by experienced physician assistants were comparable in safety and efficacy to those provided by physicians.