POSTER ABSTRACTS: P5 IMPACT OF THE COVID-19 PANDEMIC ON ABORTION SERVICES: PROVIDER PERSPECTIVES

Objectives: Canada was positioned to transition to telemedicine abortion care during the COVID-19 pandemic because REMs-like mifepristone restrictions were removed previously. We sought to characterize the impact of the pandemic response on Canadian clinical practice and abortion care access from the provider perspective. Methods: This was a sequential mixed methods study conducted between July 2020 and January 2021. A national sample of abortion providers completed a survey containing an open-ended question about the impact of the pandemic response. We took an inductive thematic approach to analysis that informed a second, primarily quantitative, survey. Results: The first survey was completed by 307 participants and the second by 78. Overall, 85% were physicians, 6% were nurse practitioners, and the remainder were pharmacists or administrators. Our thematic analysis identified 3 topics: access to abortion care, which was usually maintained despite pandemic-related challenges (eg difficulty obtaining tests, reduced operating time, limited referral pathways, new costs);change of practice to low- and no-touch medication abortion care;and provider perceptions of the patient experience, including shifting demand, good telemedicine acceptability, and increased rural access. The second survey showed uptake of telemedicine medication abortion among 89% of participants outside the province of Quebec, where uptake was 33%. Pandemic-related restrictions did not delay care according to 76% of participants. Conclusions: The pandemic led to a robust transition to telemedicine abortion care in most of Canada, facilitated by prior removal of mifepristone restrictions and consideration of abortion as essential. Our findings could inform innovation in medication abortion service delivery in the US setting.