Our active research network has numerous studies underway.
The CART Mife-Outcomes study
Access to abortion is inequitable in Canada. Most abortions are provided using surgery and are available only in large cities. Those living in rural and remote communities face particular difficulties to accessing abortion care. In 2017, Canada introduced mifepristone, a drug used for medical abortion. Because of Canada's unique mifepristone policies, this form of abortion could be available in primary care settings, which may improve abortion access in Canada through delivery closer- to-home. However, the actual impact of mifepristone introduction on abortion access, outcomes, and costs in Canada is not yet known. Also, countries around the world seek to understand the effects of Canada's unique deregulation of medical abortion.
In this study, we will measure the impact of mifepristone introduction on abortion access, outcomes, and costs using Canada's comprehensive health administrative data. Research question: How has mifepristone medical abortion affected abortion access and service distribution, adverse event rates, and health system costs in Canada? Methods: This study uses linked population-based health administrative data to examine abortion outcomes, access, and costs for abortions before and after mifepristone introduction, in British Columbia and Ontario. Our team has conducted foundational mifepristone implementation research engaging health policy, system, service decision makers as well as health professionals. Federal and provincial health policymakers and system leaders are integrated into our research team to facilitate timely improvements. This study builds on our prior work which supports integrated knowledge translation of the results. Impact: This will be the first comprehensive examination of abortion services in Canada following mifepristone introduction, and will enable health policy, system and service delivery decision makers to further equitable access to safe, effective abortion care for patients across Canada and around the world.
Interpregnancy Interval and Pregnancy Outcomes
Pregnancies following short interpregnancy intervals (conceived within 12 or 18 months of a prior delivery) are linked with increased risks of adverse pregnancy outcomes, including preterm birth, poor fetal growth leading to small-for-gestational age birth or low birthweight, and infant death. Current North American guidelines recommend that women wait a minimum of 18 months before becoming pregnant again, while the World Health Organization advises waiting at least 24 months. As preventing short interpregnancy intervals may be a strategy to reduce the burden of adverse fetal and infant outcomes, short interpregnancy intervals (<18 months) are monitored as a public health indicator in many countries across the globe, including the US.
In this study, we will identify the optimal interpregnancy interval range for three high-risk obstetric populations that currently lack evidence to inform pregnancy spacing decisions. The findings of this study will inform pregnancy spacing recommendations to optimize healthy pregnancy and fetal and infant outcomes in these high-risk obstetric populations that most need targeted evidence to support pregnancy spacing decision-making.
Early pregnancy loss incidence in high income settings: a systematic review
Early pregnancy loss (unintended pregnancy loss before 20 completed weeks of gestation) is a common adverse pregnancy outcome, with previous evidence reporting incidence ranging from 10% to 30% of detected pregnancies. The objective of this systematic review is to determine the incidence and range of early pregnancy loss in contemporary pregnant populations based on studies with good internal and external validity. Findings may be useful for clinical counseling in pre-conception and family planning settings, and for people who experience an early pregnancy loss.
Canadian Abortion Provider Survey (CAPS) 2019
The Canadian Abortion Provider Survey (CAPS) 2019 is a CIHR funded study that examines characteristics of the Canadian abortion provider workforce, their quality of care and experience with stigma and harassment, particularly in relation to the 2017 introduction of mifepristone and publication of new SOGC clinical care guidelines.
The specific aims of the survey are:
- Document the change in characteristics and distribution of the abortion care workforce since the 2012 Canadian Abortion Provider Survey;
- Assess the quality of care, i.e., characteristics of actual abortion practices as compared to the revised Canadian clinical practice guidelines, in both medical abortion and surgical abortion practices and;
- Determine to what extent providers experience harassment and stigma in their work and explore their related resilience and retention.
Available from July to December 2020, we conducted a cross-sectional, self-administered survey of physicians, nurse practitioners, and administrators who provided abortion care in 2019. English and French surveys were available online, and recruitment materials were distributed through various health care organizations and networks. Our goal is to provide high-quality pan-Canadian survey data to inform abortion care planning for leaders of health policy, systems, services, and professional organizations in order to ensure and improve equitable high-quality abortion care in Canada.
For more information, please click here.
Click on the button below to read summaries of some of our other current projects.