Edith Raphaëlle Guilbert

Université Laval | ULAVAL · Department of Obstetrics and Gynecology

Objective: Our objective was to explore the workforce and clinical care of first and second trimester surgical abortion (FTSA, STSA) providers following the publication of updated Society of Obstetricians and Gynaecologists of Canada (SOGC) surgical abortion guidelines. Methods: We conducted a national, cross-sectional, online, self-administered...

Background Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since a 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPS 2019 survey instrument to explore changes of the abortion provider workforce, their clinical care as well as expe...

Mifepristone medication abortion was first approved in China and France more than 30 years ago and is now used in more than 60 countries worldwide. It is a highly safe and effective method that has the potential to increase population access to abortion in early pregnancy, closer to home. In both Canada and the United States, the initial regulation...

Objective: To evaluate practices among first-trimester surgical abortion facilities and providers in Canada in 2012 and examine the characteristics of the surgical abortion work force. Design: Self-administered paper or electronic survey adapted from a survey previously fielded in the United States. Setting: Canada. Participants: Facility ad...

Objective: In 2020, 11.9% of abortions in Quebec were medication abortions, compared with 32.4% in Ontario. The objective of this evaluation was to assess the quality of access to medication abortion in abortion clinics of Quebec, where 91% of these abortions are performed. Methods: Quebec abortion clinics were contacted by two mystery client cl...

Objective: Communication of information is a key component of quality family planning services. It allows for an informed choice between surgical and medication abortion. Methods: Québec abortion clinics were contacted by 2 mystery client clinical profiles (PC) between October 8 and November 17, 2021. Data collection was done simultaneously by a...

Background: Since 2016, abortion care has undergone several important changes, particularly related to the provision of medical abortion using mifepristone. We aimed to document characteristics of the abortion care workforce in Canada after the update of clinical practice guidelines of mifepristone use for medical abortion. Methods: We conducted...

Introduction Telemedicine has the potential to improve abortion access disparities in Canada. We aimed to explore the provision of telemedicine for first-trimester medical abortion and related barriers in 2019. Methods We conducted a national, cross-sectional, anonymized, web-based survey of clinicians who provided abortion care in 2019 in Canada....

Background Virtual communities of practice (VCoPs) have been used to support innovation and quality in clinical care. The drug mifepristone was introduced in Canada in 2017 for medical abortion. We created a VCoP to support implementation of mifepristone abortion practice across Canada. Objective The aim of this study was to describe the developme...

Objective : To explore the Canadian first-trimester medication abortion (MA) workforce and their clinical care following the introduction of mifepristone in 2017, updated national clinical practice guidelines and government approval of nurse practitioners (NPs) as first-trimester MA providers. Study Design : We conducted a national, self-administe...

Objectives Mifepristone became available in Canada in 2017. Updated national guidelines recommend its off-label use for second/third-trimester medical abortion (STMA/TTMA) by labour induction. The objective of this study was to explore STMA/TTMA provision in Canada and the role of mifepristone. Methods We conducted a national, cross-sectional, web...

Background Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since a 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPs 2019 to explore changes of the abortion provider workforce, their clinical care as well as experiences with stigm...

BACKGROUND Virtual communities of practice (VCoPs) have been used to support innovation and quality in clinical care. The drug mifepristone was introduced into Canada in 2017 for medical abortion. We created a VCoP to support implementation of this medical abortion practice across Canada. OBJECTIVE To describe the development and utilization of th...

Background The COVID-19 pandemic and pandemic response created novel challenges for abortion services. Canada was uniquely positioned to transition to telemedicine because internationally common restrictions on abortion medication were removed before the pandemic. Objective We sought to characterize the experiences of abortion health care professi...

Background Since Canadian drug regulatory approval of mifepristone for medical abortion in 2015 and its market availability in January 2017, the role of pharmacists in abortion provision has changed rapidly. We sought to identify the factors that influenced the initiation and provision of medical abortion from the perspectives of Canadian pharmacis...

Objective: To provide guidance on culturally competent contraception counselling that is free of coercion and promotes shared decision-making and patient autonomy. Target population: Individuals of reproductive age who seek contraception or counselling for family planning. Options: Contraception counselling is provided within a rights-based family...

RÉSUMÉ Objectif Fournir des recommandations pour que le counseling contraceptif soit adapté à la culture, n'exerce aucune coercition et favorise la prise de décision partagée et l'autonomie de la patiente. Population cible Les personnes en âge de procréer qui consultent afin d'adopter une méthode contraceptive ou d'obtenir des conseils en plani...

Purpose: Access to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abort...

Objectives We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals, and how these factors relate to abortion policies, systems, and service access throughout Canada. Methods We conducted one-on-one semi-structured interviews at baseline (2017)...

Objectives To create a questionnaire able to explore changes in abortion services, workforce, and clinical practices compared to our 2012 Canadian survey, particularly in relationship to the 2017 introduction of mifepristone medical abortion and updated SOGC clinical guidelines. We aimed to create a cross-sectional online survey capturing demograph...

Objectives Mifepristone for first-trimester medical abortion (MA) became available in Quebec in 2018, one year after the rest of Canada. Using the transtheoretical model of change (TTM), we investigated factors influencing the implementation of mifepristone MA by physicians in Quebec. Methods Semi-structured interviews were conducted with 37 Quebe...

Objectives: Mifepristone for first-trimester medical termination of pregnancy (MTOP) became available in Quebec in 2018, one year after the rest of Canada. Using the theory of the Diffusion of Innovation (DOI) and the transtheoretical model of change (TTM), we investigated factors influencing the implementation of mifepristone MTOP in Quebec. Mater...

Objective: Mifepristone became available in Canada in January 2017, but provincial medical policy delayed its use for medical abortion (MA) in Québec for 1 year. The objective of this study was to identify barriers and facilitators experienced by physicians who could potentially provide this newer abortion practice in Québec. Methods: This study...

Background: Direct primary care provision of first-trimester medical abortion could potentially address inequitable abortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso® (mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictions to distribution...

Objectif: Fournir des lignes directrices aux fournisseurs de soins quant à l'utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d'une sexualité saine. Issues: Orientation des praticiens canadiens en ce qui concerne l'efficacité globale, le mécanisme d'action, les indications, les contre-indications,...

Objectives In 2012, only 60 doctors provided medical abortion in Canada. Mifepristone-based medical abortion is a gold standard that has now been available in Canada since 2016. While no longer mandatory, the Health Canada/SOGC/CFPC/CPhA Medical Abortion Training Program is the only comprehensive training program in the country, and this program me...

Introduction In January 2017, mifepristone-induced medical abortion was made available in Canada. In this study, we will seek to (1) understand facilitators and barriers to the implementation of mifepristone across Canada, (2) assess the impact of a ‘community of practice’ clinical and health service support platform and (3) engage in and assess th...

Objectives: To assess whether first-trimester aspiration abortion practices of U.S. providers agree with evidence-based policy guidelines. Study design: We sent surveys by mail or electronically to all abortion facilities in the U.S. identified via professional networks and websites from June through December 2013. Administrators reported on the...

Objective: This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Intended users: Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs....

Résumé Objectif La présente directive clinique examine les données probantes sur l'avortement chirurgical et l'avortement médical au deuxième trimestre, y compris les soins prodigués avant et après l'intervention. Utilisateurs cibles Gynécologues, médecins de famille, infirmières, sages-femmes, résidents et autres fournisseurs de soins de santé q...

Objective: To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines. Study design: We conducted a cross-sectional survey of abortion facilities in the U.S. identified via publicly available resources and professional networks from June through December 2013. Results: Of 703 id...

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We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per...

Objectif: Mettre à la disposition des fournisseurs de soins des lignes directrices concernant le recours à des méthodes contraceptives pour prévenir la grossesse et la promotion d'une sexualité saine. Issues: Efficacité globale des méthodes contraceptives citées : évaluation de l'innocuité, des effets indésirables et de la baisse du taux de gros...

Objective: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, and side effects; the effect of cited contraceptive methods on sexual health and g...

L’objectif de cet article est de présenter une mise à jour sur l’utilisation des méthodes contraceptives, y compris la contraception d’urgence, chez les femmes sexuellement actives qui fréquentent les cégeps et les universités du Québec. Cet article puise dans deux études sur la santé sexuelle menées en milieu collégial et universitaire (ESS-UQAM e...

Résumé Objectif Analyser les connaissances actuelles au sujet de la contraception d’urgence (CU), y compris les options disponibles, leurs modes d’action, leur efficacité, leur innocuité et l’offre efficace d’une CU en milieu de pratique. Options Le schéma posologique combiné estradiol-lévonorgestrel (schéma posologique Yuzpe) et le schéma posolo...

Objective: Abortion is one of the most common medical procedures a woman experiences in her lifetime. Even though overall rates of abortion are decreasing slightly, medical abortion rates are expected to increase in Canada following approval by Health Canada of a combination of mifepristone and misoprostol for use in medical abortion. Methods: W...

Objective To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers. Design An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distr...

Objective: This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. Intended users: Gynaecologists, family physicians, registered nurses, mi...

Objective To understand the current availability and practice of first-trimester medical abortion (MA) in Canada. Design Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or electronic...

Objectif: La présente directive clinique passe en revue les données probantes traitant des paramètres entourant l'offre d'un avortement provoqué médical au premier trimestre, dont les critères d'admissibilité, le counseling, le consentement, les schémas posologiques fondés sur des données probantes et les facteurs particuliers à prendre en considé...

Objective: To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers. Design: An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was d...

Objective: To understand the current availability and practice of first-trimester medical abortion (MA) in Canada. Design: Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or elect...

Objective: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual...

Objectif: Fournir des lignes directrices aux fournisseurs de soins quant à l'utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d'une sexualité saine. Issues: Orientation des praticiens canadiens en ce qui concerne l'efficacité globale, le mécanisme d'action, les indications, les contre-indications,...

Objective: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual...

Objective: Unintended pregnancies (UPs) are associated with a significant cost burden, but the full cost burden in Canada is not known. The objectives of this study were to quantify the direct cost of UPs in Canada, the proportion of cost attributable to UPs and imperfect contraceptive adherence and the potential cost savings with increased uptake...

Objective To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation...

Objective: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality . Outcomes: Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiatio...

Résumé Objectif Fournir des lignes directrices aux fournisseurs de soins quant à l'utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d'une sexualité saine. Issues Orientation des praticiens canadiens en ce qui concerne l'efficacité globale, le mécanisme d'action, les indications, les contre-indicatio...

Objective To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation...

Résumé Objectif Fournir des lignes directrices aux fournisseurs de soins quant à l'utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d'une sexualité saine. Issues Orientation des praticiens canadiens en ce qui concerne l'efficacité globale, le mécanisme d'action, les indications, les contre-indicatio...

Objective To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Outcomes Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation...

Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Semi-...

L’avant-midi sera consacré à l’exploration des données issues des plus récentes études sur la santé sexuelle des jeunes adultes au Québec, notamment celles de PIXEL, un portrait sur la santé sexuelles des jeunes adultes de moins de 25 ans au Québec et d’autres initiatives menées par l’Université du Québec à Montréal. Il s’agira d’un circuit aux esc...

Objective To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers. Design An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distri...

In 2007, a task-shifting strategy through which a nurse, in collaboration with a community pharmacist, could start a healthy woman on hormonal contraception without a medical consultation was implemented in the province of Quebec. The purpose of this study was to identify factors associated with the 1) implementation of this new practice by nurses,...

Objectives: Since 2000, the Province of Quebec has experienced a shortage of physicians and a decrease in access to prescription contraceptives. A task-shifting strategy was launched in 2007 to allow trained nurses, in collaboration with community pharmacists, to start healthy women on hormonal contraception for a six-month period without a medica...

To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting. The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital use of copper intrauterine devices, are r...

Objective: To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting. Options: The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital use of copper intraut...

Analyser les connaissances actuelles au sujet de la contraception d’urgence (CU), y compris les options disponibles, leurs modes d’action, leur efficacité, leur innocuité et l’offre efficace d’une CU en milieu de pratique.

To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting.

Guilbert ER, Morin D, Guilbert AC, Gagnon H, Robitaille J, Richardson M. International Journal of Nursing Practice 2011; 17: 315–321 Task-shifting in the delivery of hormonal contraceptive methods: Validation of a questionnaire and preliminary results In order to palliate the access problem to effective contraceptive methods in Quebec, Canada, as w...

Our objective was to compare the use of misoprostol to that of laminaria tents for dilatation of the cervix before a surgical elective abortion (EAB) during the first trimester, with regard to the pain caused (1) during insertion, for both methods, (2) immediately before the EAB, and (3) one hour after the procedure. One hundred two women were recr...

Past studies indicate that despite a wide range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods. New contraceptive methods have recently been introduced in Canada. The objective of this research is to characterize Canadian women's current contraceptive choices and adherence to contraceptive regimens....

Since the approval of injectable medroxyprogesterone acetate (DMPA Depo-Provera®) in the United States in 1992 and Canada in 1997 and the subsequent "black box" warnings in both countries DMPA has been the object of more than a hundred publications including many focusing on its impact on bone mineral density. Apart from these scientific publicatio...

Background: In the fall of 2007, the controversy about the contraceptive use of depot-medroxyprogesterone acetate (DMPA) and its potential impact on skeletal health reached the media in the province of Quebec, Canada, thereby becoming a matter of concern for the lay public and physicians. In order to discuss this subject openly, the National Insti...

To provide evidence-based guidance for women and their health care providers on the management of missed or delayed hormonal contraceptive doses in order to prevent unintended pregnancy. Medline, PubMed, and the Cochrane Database were searched for articles published in English, from 1974 to 2007, about hormonal contraceptive methods that are availa...

Offrir des conseils factuels aux femmes et à leurs fournisseurs de soins de santé quant à la prise en charge de l’oubli ou de la prise différée d’une ou de plusieurs doses de contraceptif hormonal, afin de prévenir les grossesses non souhaitées.

The study was conducted to evaluate the safety and acceptability of the Invisible Condom when applied once or twice daily for 14 days in healthy women and their male sexual partners. Forty-one women and 23 men divided into three cohorts were enrolled. Cohort 1:14 sexually abstinent women applying gel twice daily for 14 days; Cohort 2:14 sexually ac...

To serve as a guideline for health care providers on the use of continuous and extended combined hormonal contraception regimens, to prevent pregnancy, and to delay menses that affe