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August 2004, Vol 94, No. 8 | American Journal of Public Health 1352-1357
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Physician Assistants as Providers of Surgically Induced Abortion Services

Marlene B. Goldman, SM, ScD, Jane S. Occhiuto, RN, SM, Laura E. Peterson, BSN, SM, Jane G. Zapka, ScD and R. Heather Palmer, MB, BCh, SM

Marlene B. Goldman is with the Department of Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass. Jane S. Occhiuto is with the Department of Epidemiology and Laura E. Peterson and R. Heather Palmer are with the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass. Jane G. Zapka is with the Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Mass.

Correspondence: Requests for reprints should be sent to Marlene B. Goldman, SM, ScD, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 (e-mail: mgoldman{at}bidmc.harvard.edu).

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.




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