Knowledge of medication abortion among adolescent medicine providers

Purpose: Adolescents are at high risk for unintended pregnancy and abortion. The purpose of this study was to understand whether providers caring for adolescents have the knowledge to counsel accurately on medication abortion, a suitable option for many teenagers seeking to terminate a pregnancy.

Methods: Using an online questionnaire, a survey related to medication abortion was administered to U.S. providers in the Society for Adolescent Health and Medicine. We conducted χ(2) analyses to evaluate the knowledge of medication abortion by reported adolescent medicine fellowship training, and to compare responses to specific knowledge questions by medication abortion counseling. Furthermore, we examined the relationship between providers' self-assessed and actual knowledge using ANOVA.

Results: We surveyed 797 providers, with a 54% response rate. Almost 25% of respondents incorrectly believed that medication abortion was not very safe, 40% misidentified that it was < 95% effective, and 32% did not select the correct maximum recommended gestational age (7-9 weeks). Providers had difficulty identifying that serious complications of medication abortion are rare. Those who counseled on medication abortion had more accurate information in all knowledge categories, except for expected outcomes. Medication abortion knowledge did not differ by adolescent medicine fellowship completion. Only 32% of respondents had very good knowledge, and self-assessed knowledge minimally predicted actual knowledge (r(2) = .08).

Conclusions: Knowledge regarding medication abortion safety, effectiveness, expected outcomes, and complications is suboptimal even among adolescent medicine fellowship trained physicians, and self-assessment poorly predicts actual knowledge. To ensure pregnant teenagers receive accurate counseling on all options, adolescent medicine providers need better education on medication abortion.