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Am J Perinatol 2012; 29(09): 709-716
DOI: 10.1055/s-0032-1314893
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal-Fetal Medicine Subspecialists' Provision of Second-Trimester Termination Services

Jennifer L. Kerns
1   Division of San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
,
Jody E. Steinauer
1   Division of San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
,
Melissa G. Rosenstein
1   Division of San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
,
Jema K. Turk
1   Division of San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
,
Aaron B. Caughey
2   Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
,
Mary D'Alton
3   Department of Obstetrics and Gynecology, Columbia University, New York, New York
› Author Affiliations
Further Information

Publication History

13 January 2012

23 February 2012

Publication Date:
25 May 2012 (online)

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Abstract

Objective Most abortions for pregnancy complications occur in the second trimester. Little is known about whether maternal-fetal medicine subspecialists (MFMs) perform terminations for these women.

Study Design We surveyed all members of Society of Maternal Fetal Medicine by e-mail or mail regarding second-trimester abortion provision. We conducted analyses of whether MFMs perform abortions, by what method, and how frequently.

Results Our response rate was 32.4% (689/2,125). Over two-thirds of respondents perform either dilation and evacuation (D&E) or induction; 31% perform D&Es. Male gender, frequent chorionic villus sampling provision, and being trained in D&E during fellowship are associated with performing D&Es. Nonprovision of any second-trimester abortion is significantly associated with age over 50, nonacademic practice setting, and less supportive abortion attitudes (p < 0.001). A nonsignificant trend toward association between south/southeast region and nonprovision of any second-trimester abortion is seen (p = 0.09).

Conclusion Many MFMs include D&E and induction termination services in their practice. Supporting current D&E providers and expanding training options for MFMs may optimize care for women diagnosed with serious pregnancy complications.

Keywords

fetal anomalies - fetal demise - pregnancy complications - termination of pregnancy
 

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