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. 2022 Apr 29;72(722):e677-e683.
doi: 10.3399/BJGP.2021.0704. Online ahead of print.

Dutch GPs' views on prescribing mifepristone and misoprostol: a mixed-methods study

Julia Eap Schellekens  1 , Claire Se Houtvast  2 , Peter Leusink  3 , Gunilla Kleiverda  4 , Rebecca Gomperts  5
Affiliations

Dutch GPs' views on prescribing mifepristone and misoprostol: a mixed-methods study

Julia Eap Schellekens et al. Br J Gen Pract. .

Abstract

Background: The World Health Organization has indicated that GPs can safely and effectively provide mifepristone and misoprostol for medical termination of pregnancy (TOP). Dutch GPs are allowed to treat miscarriages with mifepristone and misoprostol, but few do so. Current Dutch abortion law prohibits GPs from prescribing these medications for medical TOP. Medical TOP is limited to the specialised settings of abortion clinics and hospitals. Recently, the House of Representatives debated shifting abortion to the domain of primary care, following the example of France and the Republic of Ireland. This would improve access to sexual and reproductive health care, and increase choices for women. Nevertheless, little is known about GPs' willingness to provide medical TOP and miscarriage management.

Aim: To gain insight into Dutch GPs' willingness to prescribe mifepristone and misoprostol for medical TOP and miscarriages, as well as the anticipated barriers.

Design and setting: Mixed-methods study among Dutch GPs.

Method: A questionnaire provided quantitative data that were analysed using descriptive methods. Thematic analyses were performed on qualitative data collected through in-depth interviews.

Results: The questionnaire was sent to 575 GPs; the response rate was 22.1% (n = 127). Of the responders, 84.3% (n = 107) were willing to prescribe mifepristone and misoprostol, with 58.3% (n = 74) willing to provide this medication for both medical TOP and miscarriage management. A total of 57.5% (n = 73) of participants indicated a need for training. The main barriers influencing participants' willingness to provide medical TOP and miscarriage management were lack of experience, lack of knowledge, time constraints, and a restrictive abortion law.

Conclusion: Over 80.0% of responders were willing to prescribe mifepristone and misoprostol for medical TOP or miscarriages. Training, (online) education, and a revision of the abortion law are recommended.

Keywords: Netherlands; abortion, induced; abortion, missed; general practitioners; mifepristone; misoprostol.

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Figures

Figure 1.
Figure 1.
Flowchart showing the participation rate for the quantitative and qualitative parts of the study.
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References

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