Obstetrician-gynecologists' knowledge of and attitudes toward medical abortion in Guatemala

Objective: To characterize the legal and clinical knowledge of Guatemalan obstetrician gynecologists (OB/GYNs) regarding medical abortion and to determine factors associated with approval of its use for specific indications. Methods: A trained interviewer administered a multiple-choice survey to 172 private-practice OB/GYNs across Guatemala. Univariate, bivariate, and multivariate analyses characterized medical abortion opinion and knowledge, and logistic regression identified influential factors. Results: 73% of OB/GYNs knew that abortion is legally permitted when the woman's life is at risk. Although 92% knew that misoprostol can be used to induce abortion, only 35% knew the WHO-recommended dosage. Only 25% knew of mifepristone. Compared with older OB/GYNs, those under 40 years of age were 7 times more likely, and 40-49 year olds were twice as likely to approve of medical abortion for fetal death and severe eclampsia with fetal death, respectively. Conclusion: Current indications for abortion under Guatemalan law, as well as OB/GYN practices and beliefs regarding medical abortion, are hindering women's access to safe medical abortion and, therefore, potential reductions in maternal morbidity and mortality. Future research should aim to identify whether and why Guatemalan OB/GYNs are unfamiliar with these drugs, prefer to use other methods, or are completely against abortion. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.