Understanding Abortion Care in New Brunswick Emergency Departments

Background and Objectives: In New Brunswick (NB), the emergency department (ED) is an important setting responsible for providing many forms of reproductive health care, yet the role of the NB ED in providing abortion services remains unclear.This is increasingly important as limited primary care access in NB has resulted in more patients turning to EDs for primary care concerns, including reproductive health care.This study aimed to understand the experiences of health care providers working in NB EDs with respect to abortion care.Methods: I conducted semi-structured interviews with physicians, medical residents, and nurse practitioners working in NB EDs.I performed reflexive thematic analysis of the qualitative data to generate themes.Results: I collected data from six participants.Three key themes emerged: (1) The ideal abortion; (2) The role of the ED provider; (3) Referral over provision.Subthemes included The ED as a safety net, and Knowledge limits care.Discussion: Findings suggest that ED health care providers often balance the competing priorities of ideal care versus accessible care within the realities of emergency medicine.Notably, the ED is increasingly viewed as a safety net for patients facing barriers to community care; however, direct provision of abortion care in the ED is uncommon.Patients seeking abortion care are often referred elsewhere, a practice that is largely influenced by provider knowledge and comfort, by perspectives on the role of the ED, and by perceptions around the ability to provide patients with "ideal" abortion care in an ED setting.Conclusions: Findings highlight opportunities to address ED provider knowledge gaps related to abortion care; likewise, findings suggest there is a need to clarify and strengthen abortion care pathways for patients seen in NB EDs.Future research should explore patient perspectives and priorities to further inform patient-centred abortion care delivery in NB.