Women's experiences when unsure about whether or not to have an abortion in the first trimester

Abstract Background The abortion law in Uruguay changed in 2012 to allow first trimester abortion on request. Implementation of the law in Uruguay has been lauded, but barriers to care, including abortion stigma, remain. This study aimed to assess women’s experiences seeking abortion services and related attitudes and knowledge following implementation of the law in Uruguay. Methods We interviewed 207 eligible women seeking abortion services at a high-volume public hospital in Montevideo in 2014. We generated univariate frequencies to describe women’s experiences in care. We conducted regression analysis to examine variations in experiences of stigma by women’s age and number of abortions. Results Most of the women felt that abortion was a right, were satisfied with the services they received, and agreed with the abortion law. However, 70% found the five-day waiting period unnecessary. Women experienced greater self-judgement than worries about being judged by others. Younger women in the sample (ages 18–21) reported being more worried about judgment than women 22 years or older (1.02 vs. 0.71 on the ILAS sub-scale). One quarter of participants reported feeling judged while obtaining services. Women with more than one abortion had nearly three times the odds of reporting feeling judged. Conclusions These findings highlight the need to address abortion stigma even after the law is changed. Some considerations from Uruguay that may be relevant to other jurisdictions reforming abortion laws include: the need for strategies to reduce judgmental behavior from staff and clinicians towards women seeking abortions, including training in counseling skills and empathic communication; addressing stigmatizing attitudes about abortion through community outreach or communications campaigns; mitigating the potential stigma that may be perpetuated through policies to prevent “repeat” abortions; ensuring that younger women and those with more than one abortion feel welcome and are not mistreated during care; and assessing the necessity of a waiting period. The rapid implementation of legal, voluntary abortion services in Uruguay can serve in many ways as an exemplar, and these findings may inform the process of abortion law reform in other countries.

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Self-management of first trimester medical termination of pregnancy: a qualitative study of women's experiences

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.14690 ◽

2017 ◽

Vol 124 (13) ◽

pp. 2001-2008 ◽

Cited By ~ 8

Author(s):

C Purcell ◽

S Cameron ◽

J Lawton ◽

A Glasier ◽

J Harden

Keyword(s):

Qualitative Study ◽

First Trimester ◽

Termination Of Pregnancy ◽

Self Management ◽

Women’S Experiences ◽

Medical Termination Of Pregnancy ◽

Women's Experiences ◽

Medical Termination

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Accessing medical and surgical first-trimester abortion services: women's experiences and costs from an operations research study in KwaZulu-Natal Province, South Africa

Contraception ◽

10.1016/j.contraception.2017.03.013 ◽

2017 ◽

Vol 96 (2) ◽

pp. 72-80 ◽

Cited By ~ 7

Author(s):

Naomi Lince-Deroche ◽

Tamara Fetters ◽

Edina Sinanovic ◽

Kelly Blanchard

Keyword(s):

South Africa ◽

Operations Research ◽

Research Study ◽

First Trimester ◽

Trimester Abortion ◽

Women’S Experiences ◽

Women's Experiences ◽

Kwazulu Natal

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Beyond autonomy and care: Experiences of ambivalent abortion seekers

Nursing Ethics ◽

10.1177/0969733018819128 ◽

2019 ◽

Vol 26 (7-8) ◽

pp. 2135-2146

Author(s):

Marianne Kjelsvik ◽

Ragnhild J Tveit Sekse ◽

Asgjerd Litleré Moi ◽

Elin M Aasen ◽

Per Nortvedt ◽

...

Keyword(s):

Decision Making ◽

Health Personnel ◽

First Trimester ◽

Outpatient Clinics ◽

Ethical Considerations ◽

Women’S Experiences ◽

Individual Interviews ◽

Women's Experiences ◽

Before And After ◽

Regional Committee

Background: While being prepared for abortions, some women experience decisional ambivalence during their encounters with health personnel at the hospital. Women’s experiences with these encounters have rarely been examined. Objective: The objective of this study was to explore ambivalent abortion-seeking women’s experiences of their encounters with health personnel. Research design: The data were collected in individual interviews and analysed with dialogical narrative analyses. Participants and research context: A total of 13 women (aged 18–36 years), who were uncertain of whether to terminate their pregnancies during the first trimester, were interviewed before and after they made their decisions. The participants were recruited at six Norwegian outpatient clinics. Ethical considerations: Approval was granted by the Regional Committee for Medical and Health Research Ethics. Findings: The ambivalent pregnant women sought to make autonomous decisions while simultaneously involving their closest confidants and health personnel in the process. The following three types of narratives of women’s experiences with encounters with health personnel were identified: the respected women; the identified women; and the abandoned women. Discussion: The findings are discussed in terms of the ambivalent pregnant woman’s autonomous responsibility in considering an abortion and how her autonomy can be enabled or impaired during encounters with health personnel. Conclusion and implication: Although the women considered themselves autonomous and responsible for their final decisions, they wished health personnel were involved in their situations. The health personnel contributed by enabling or disabling the possibility of decision-making in accordance with the women’s values. The findings indicate that health personnel who care for women considering abortions must be trained in dialogical competence.

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