Many patients in Vermont need to seek abortion care outside of their regular doctors office. When a patient discovers that she is pregnant there should be a non-biased conversation about options as part of The Patient Centered Medical Home. This resource includes: where to go for an abortion, how to pay for it, who to call for support, and advice on how to avoid biased institutions.https://scholarworks.uvm.edu/fmclerk/1237/thumbnail.jp

Robinson, Andre A

ScholarWorks @ UVM

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects College of Medicine2016Abortion Resources Patient Handout SmartPhraseAndre A. RobinsonUVMFollow this and additional works at: http://scholarworks.uvm.edu/fmclerkPart of the Family Medicine Commons, Medical Education Commons, Primary Care Commons,and the Women's Health CommonsThis Book is brought to you for free and open access by the College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion in FamilyMedicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationRobinson, Andre A., "Abortion Resources Patient Handout SmartPhrase" (2016). Family Medicine Clerkship Student Projects. Book197.http://scholarworks.uvm.edu/fmclerk/197Patient Resources for Abortion CareSmartPhraseBy Andre Robinson, UVM College of Medicine Class of 2018Family Medicine Clerkship: UVMMC-Berlin (Berlin, VT)September, 2016 Project Mentors: Jennifer Bamford, MD & Clara Keegan, MDProblem IdentificationMany patients in Vermont need to seek abortion care outside of their regular doctors office. Some patients may feel uncomfortable or ashamed to talk with their doctor. When a patient discovers that she is pregnant there should be a non-biased conversation about options as part of The Patient Centered Medical Home. There are no informational handouts in PRISM that provide resources including where to get an abortion, how to decide what your options are, the cost of an abortion, or warnings about biased organizations that may compromise a patient’s health. • Nearly half of pregnancies among American women in 2011 were unintended, and about four in 10 of these were terminated by abortion. [1]• In 2010, 46% of all pregnancies (4,000) in Vermont were unintended [2]• In 2010, 51% of unintended pregnancies in Vermont resulted in births and 35% in abortions; the remainder resulted in miscarriages. [2]• The teen pregnancy rate in Vermont was 32 per 1,000 women aged 15–19 in 2010. [3]• In 2011, 79% of Vermont counties had no abortion clinic. 51% of Vermont women lived in these counties. [4]Public Health Costs • Forty-nine percent of abortion patients in 2014 had incomes of less than 100% of the federal poverty level ($11,670 for a single adult with no children). [5]• In Vermont in 2010, the federal and state governments spent $31.4 million on unintended pregnancies; of this, $21.8 million was paid by the federal government and $9.6 million was paid by the state. [6]• The total public costs for unintended pregnancies in 2010 was $265 per woman aged 15–44 in Vermont, compared with $201 per woman nationally. [6]• In 2013, 35,860 Vermont women aged 13–44 were in need of publicly funded family planning services. [7]Community Perspective • Vermont in one of the few states with minimal restrictions on using mifepristone and misoprostol for abortion care. Furthermore, Vermont allows nurse practitioners and physician’s assistants to prescribe abortion medication. However, there remains a delay in the use of these drugs in practices outside of Planned Parenthood. In various practices around Vermont, credentialing affects the ease of initiating this type of treatment and political factors may influence a providers willingness to prescribe. – Clara Keegan, MD. • We assume that many people know to go to Planned Parenthood for these kinds of services, but, especially for adolescents, the information on where to go for help and who to talk to during this difficult time should be made clear. –Jennifer Bamford, MD.Intervention and Methodology UVM Medical Center Patient Resources Considering Abortion? If you are pregnant, you have three options to think about — abortion, adoption, and parenting. Only you can decide what is right for you, but women often find it helpful to talk it through with someone else. This resource will tell you where to go for an abortion and who to call for support.   Abortion Centers in Vermont: Planned Parenthood provides high-quality health care and can help answer your questions about abortion. To learn more contact your local office: https://www.plannedparenthood.org/  Planned Parenthood Northern New England Barre, VT (802) 476-6696  Planned Parenthood Northern New England Burlington, VT (802) 863-6326  Planned Parenthood Northern New England Rutland, VT (802) 775-2333  Planned Parenthood Northern New England White River Junction, VT  (802) 281-6056   Women’s Services at The UVM Medical Center If you are less than 10 weeks pregnant, you may qualify to have an abortion with a pills that you swallow.  (802) 847-1400  Phone Support: Backline promotes unconditional and judgment-free support for people in all their decisions, feelings and experiences with pregnancy, parenting, adoption and abortion. https://www.yourbackline.org/  Toll-Free Talk Line  1-888-493-0092 Weekdays: 10:00 A.M.-1:00 A.M. Eastern Time Saturdays & Sundays: 10:00 A.M- 6:00 P.M.  The National Abortion Federation believes in every woman’s ability to make informed decisions about her reproductive health. Our resources and network help women think through their options whether it be abortion, adoption or parenthood. https://prochoice.org/  Toll-Free Multilingual Talk Line 1-800-772-9100 Weekdays: 7:00 A.M.-11:00 P.M. Eastern Time Saturdays & Sundays: 9:00 A.M.-9:00 P.M.  Exhale provides emotional support, resources, and information to women who have had abortions, as well as to their partners, family, friends and allies.  https://exhaleprovoice.org/  Toll-Free Multilingual Talk Line  1-866-439-4253 Weekdays: 8:00 P.M.-1:00 A.M. Eastern Time Saturdays & Sundays: 3:00 P.M- 1:00 A.M.  Cost: Vermont Access to Reproductive Freedom If you live in Vermont and need help paying for your abortion, or if you are an out-of-state resident travelling to Vermont for an abortion, the Vermont Access to Reproductive Freedom (VARF) Fund may be able to help.  http://vermontaccess.org/    Toll-Free Hotline  1-800-491-8273 Please leave a voicemail and someone will call you back within 24 hours.   Green Mountain Care Covers Abortion If you are enrolled in Green Mountain Care, Medicaid, or Dr. Dynasaur, ask your clinic or hospital if they will accept your abortion coverage. https://greenmountaincare.vermont.gov/ There are two Green Mountain Care programs that cover abortion: Dr. Dynasaur and Medicaid. You can fill out one application to be considered for both programs. To determine if you are eligible to apply: Call Toll-Free  1-800-250-8427  Caution: There are some places out there that call themselves clinics, but don’t actually perform abortions. These “Crisis Pregnancy Centers” are often listed in phone books under Abortion or Abortion Alternatives. They also show up when you do Internet searches for “abortion.” They often will offer you free pregnancy tests or free ultrasounds, but the people who perform these services are not doctors. The crisis pregnancy centers are anti-abortion and they will try to convince you not to have an abortion, often by giving you false information about the risks or costs of abortion. To protect yourself, you should never give your medical information to anyone who is not a doctor or working for a doctor’s office. Examples include: Vermont Right to Life Committee http://www.vrlc.net/resources/links-2/ Vermont Teens for Life http://www.teensforlifevt.net/ Vermont Alliance for Ethical Health Care http://www.vaeh.org/ True Dignity Vermont http://truedignityvt.org/ Roman Catholic Diocese of Burlington http://www.vermontcatholic.org/index.php?sid=5&pid=582&subnav_id=95 True North Reports http://truenorthreports.com/   Created by Andre Robinson, UVM College of Medicine Class of 2018. Current as of: September 27, 2016 • I created a simple, easy to read handout for pregnant patients who want information on abortion care and their options. • I published the article in PRISM under the SmartPhrase“.ABORTIONRESOURCES” and informed the providers at UVMMC-Berlin Family Practice of its utility. Results• My proposal for measuring the effectiveness of this project would be qualitative:• I would like to survey local Planned Parenthood providers to determine if initiating abortion care within The Patient Centered Medical Home helps destigmatize abortion. • I am curious if this gesture of trying to bridge connect local Family Medicine providers with Planned Parenthood employees will help build rapport and trust between the two entities that will eventually lead to collaboration in supporting women’s health. This will be measured over time.Limitations• This intervention requires that the provider to feels comfortable discussing abortion. Political and ethical factors may prevent some providers from inviting a conversation about voluntary termination of pregnancy. • The intervention’s quality relies on keeping telephone numbers and websites up to date. • Resources available in the handout require access to a telephone or the internet. Future Projects1. I feel optimistic about the future of early abortions being provided by Family Medicine doctors in Vermont. Adding a list of providers specifically for medication abortion care would then be appropriate. [8]2. Pending the opening of The Family Planning Clinic (run by Clara Keegan, MD) in Burlington Vermont, another opportunity will arise. A future project may identify similarities between this clinic and Planned Parenthood, which could allow a streamlined referral system for patients to various locations, depending on where they live. This would help bridge the gap between Family Medicine and abortion care/Planned Parenthood. References 1. Finer LB and Zolna MR, Declines in unintended pregnancy in the United States, 2008–2011, New England Journal of Medicine, 2016, 374:843–852.2. Guttmacher Institute, U.S. Teenage Pregnancies, Births and Abortions, 2011: State Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2016, http://www.guttmacher.org//report_downloads/us-teen-pregnancy-state-trends-2011.3. Kost K, Unintended Pregnancy Rates at the State Level: Estimates for 2010 and Trends Since 2002 New York: Guttmacher Institute, 2015, http://www.guttmacher.org/pubs/StateUP10.pdf.4. Jones RK and Kooistra, K., Abortion Incidence and Access to Services in the United States, 2008, Perspectives on Sexual and Reproductive Health, 2011, 43(1).5. Jerman J, Jones RK and Onda T, Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008, New York: Guttmacher Institute, 2016.6. Sonfield A and Kost K, Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010, New York: Guttmacher Institute, 2015, http://www.guttmacher.org/pubs/public-costs-of-UP-2010.pdf. 7. Frost JJ, Frohwirth L and Zolna MR, Contraceptive Needs and Services, 2013 Update, New York: Guttmacher Institute, 2015, http:/www.guttmacher.org/pubs/win/contraceptive-needs-2013.pdf.8. Special tabulations of data from Centers for Disease Control and Prevention, Abortion surveillance—United States, 2012, Morbidity and Mortality Weekly Report, 2015, Vol. 64, No. SS-10.

Abortion Resources Patient Handout SmartPhrase

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