• Na'amah Razon, Sarah Wulf, Citlali Perez, Sarah McNeil, Lisa Maldonado, Alison Byrne Fields, Kelsey Holt, Edith Fox, Ilana Silverstein, and Christine Dehlendorf.
• From the Department of Family and Community Medicine, University of California, Davis, Sacramento, CA (NR); Person-Centered Reproductive Health Program, Department of Family and Community Medicine, University of California, San Francisco, CA (SW, CP, KH, EF, IS and CD); Departments of Family Medicine and Ob/Gyn, Contra Costa Regional Medical Center, Martinez, CA (SM); Reproductive Health Access Project, New York, NY (LM); Aggregate, Seattle, WA (BF). nrazon@ucdavis.edu.
• J Am Board Fam Med. 2022 May 1; 35 (3): 579-587.

PurposeMedication abortion (MAB) provision by family physicians has the potential to expand abortion access. However, there are documented individual and structural barriers to provision. This study investigates how family physicians in the United States (US) navigate the barriers impeding abortion provision in primary care.MethodsWe conducted a qualitative study on the experiences of US family physicians with MAB in primary care. We recruited participants at national conferences and via professional networks. This analysis focuses on the experiences of the subset of participants who expressed interest in providing MAB.ResultsForty-eight participants met inclusion criteria, with representation from all 4 regions of the US. Participants had diverse experiences related to abortion provision, training, and the environment in which they practice, with a third of participants working in states with hostile abortion policies. We categorized participants into 3 groups: (1) doctors who did not receive training and do not provide abortions (n = 11), (2) doctors who received training but do not provide abortions (n = 20), and (3) doctors who received training and currently provide abortions (n = 17). We found that training, administrative and community support, and internal motivation to overcome barriers help family physicians integrate MAB in primary care practices. Federal and state laws, absence of training, stigma around abortion provision, inaccurate or limited knowledge of institutional barriers, and administrative resistance all contributed to doctors excluding abortion provision from their scope of practice.ConclusionImproving medication abortion provision by family physicians requires addressing the individual and system barriers family physicians encounter so they receive the education, training, and support to successfully integrate abortion care into clinical practice.© Copyright 2022 by the American Board of Family Medicine.

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