A comparison of termination of pregnancy procedures: Patient choice,emotional impact and satisfaction with care |
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| Institution: | 1. Gynuity Health Projects, 220 East 42nd Street New York, NY 10017;2. Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038, USA;3. Department of Obstetrics, Gynecology, and Women''s Health, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, Suite 824, Honolulu, HI 96826;4. Society of Family Planning, 225 South 17th Street, Suite 2709, Philadelphia, PA 19103-0046;5. Oregon Health & Science University, 3181 SW Sam Jackson Park Road, UHN 50, Portland, OR 97239;6. Maine Family Planning, PO Box 587, Augusta, ME 04332;7. Planned Parenthood Columbia Willamette, 3727 NE Martin Luther King Jr. Blvd, Portland, OR 97212;8. Choices Women''s Medical Center, 147-32 Jamaica Ave, Jamaica, NY 11435;1. Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9LN, United Kingdom;2. Medical School, University of Edinburgh, Teviot Place, Edinburgh EH8 9LN, United Kingdom;1. Finnmarkssykehuset HF, Klinikk Hammerfest, Sykehusveien 35, 9601, Hammerfest, Norway;2. Abortion Law Reform Association of New Zealand (ALRANZ), Director, Istar Limited, PO, Box 28008, Wellington 6150, New Zealand;3. The Tabbot Foundation, GPO Box 3904, Sydney, NSW 2001. Australia;4. Asociación de Clínicas Acreditadas para la Interrupción del Embarazo (ACAI), Madrid, Spain;5. Fundación Oriéntame & Fundación Educación para la Salud Reproductiva (ESAR), Carrera 18 # 33 A – 27, Bogotá, Colombia;6. Center for Research on Human Reproduction of Campinas, Campinas, SP, Brazil;7. AMASS Clinic, San Cristobal de las Casas, Mexico;8. International Campaign for Women''s Right to Safe Abortion, London, UK |
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| Abstract: | ObjectivesTo investigate: (1) whether women self-report an ability to choose their preferred termination of pregnancy (TOP) procedure, (2) what factors influence this choice, and (3) what effect this choice has on emotional responses and satisfaction with care.Study designA mixed-method prospective comparative study in which women requesting a TOP between five and eighteen weeks gestation for social reasons (as opposed to medical indications), were invited to complete a semi-structured pre-TOP interview and questionnaire, and a post-TOP questionnaire four weeks after the procedure.Main outcome measuresQuantitative data was collected using the Patient Health Questionnaire, Generalised Anxiety Disorder Scale, Positive and Negative Affect Scale, Impact of Event Scale – Revised, and Client Satisfaction Questionnaire.ResultsPre-TOP emotion-based factors did not differ between groups. Most women felt that they were able to choose their preferred method of TOP. Their decisions were based on factors categorised as procedure-related, lifestyle or social circumstance-related, emotional, or other factors. When no choice was perceived, common reasons reported were that: (1) gestation was too far along for there to be another option, or (2) an appointment was not available within the required timeframe. When women felt that the method of TOP performed was not their choice they found the procedure more stressful. All women reported high satisfaction with care.ConclusionA better understanding of the patient experience can inform service development, enabling staff to ensure that the services provided meet women’s needs. The perception that one is able to choose their preferred TOP procedure is important for reducing procedure-related stress and ensuring high satisfaction with care. |
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| Keywords: | Termination Abortion Choice Emotional impact Satisfaction with care Nursing |
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