Medical versus surgical abortion: The importance of women's choice

Contraception, 2011

Background: Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women's preferences in the decision-making process. Study Design: The data are drawn from a nationally representative survey of 8245 women undergoing an elective abortion in France in 2007. Analyses of factors associated with the type of abortion technique were performed among the 4650 women who were identified as being eligible for the two techniques. Results: Sixty-eight percent of all abortions were medical procedures among women eligible for both techniques. The type of abortion technique was not dependent on women's age, parity, cohabitation status, socioeconomic circumstances nor on the type of facility providing the abortion (private or public). Conversely, women's participation in the decision-making process was strongly associated with the type of abortion method. Among the 50% of women who reported they had been given a choice, 84% underwent a medical procedure vs. 52% of those who were not offered a choice. Among the 2286 women who were not involved in the decision, 35% indicated they trusted their doctor to make the best choice for them, while 44% were told it was too late for a medical procedure, although they had consulted before 8 weeks of amenorrhea. Conclusion: In this sample of French women who participated in a national survey on abortion, those who were involved in the decisionmaking process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure.

One Health & Risk Management

Introduction. Abortion causes problems in reproductive health, relationships in a couple, psychological and social consequences. A woman's decision to have an abortion depends on many factors, whereas in low-income countries, abortion is viewed as a method of family planning. Material and methods. A descriptive, quantitative and qualitative sample study was conducted in the Republic of Moldova from December 2021 to February 2022 to identify and evaluate the factors influencing a woman’s decision-making to terminate a pregnancy, as well as to develop recommendations for reducing the number of abortions on demand. The quantitative assessment included a survey carried out on a sample of 399 women who underwent abortions on demand. The qualitative study involved three focus group meetings, where the obstetrician-gynecologists shared their ideas upon the factors determining a woman's decision to terminate a pregnancy. Results. Analyzing the data obtained, the present research ide...

Open Journal of Obstetrics and Gynecology, 2020

Background: This research was carried out in Turkey between 20 th of April 2008 and 20 th June 2008 to women coming to childbirth and healthy child care outpatient polyclinics, public hospitals, and respective polyclinics in Adana city. Methods: This work of cross sectional study type was conducted to discover different reasons why women prefer C-section or normal delivery and knowledge, behavior, and attitude toward abortion. The questionnaire, which was developed by using the literature, was applied face to face with 395 people verbally approved. Results: 65.1% (257) of the women had no miscarriages, 54.2% (214) had one or two pregnancies and the mean number of pregnancies was 2.84 ± 2.01. While 74 (18.7%) of the women had 1 normal birth, 148 (37.5%) had 1 cesarean birth. While 203 (51.4%) of the women prefer cesarean on their own will, 32 (8.1%) stated that they had to make cesarean for medical reasons. 293 (75%) of the women stated that they had at least 1 cesarean delivery around them. Normal vaginal birth was mostly preferred by housewives. 263 (66.6%) of the women stated that they did not have any abortions and 132 (33.4%) stated that they had abortion at least once. Sixty percent of the women stated that they did not find the curettage correct. The difference between reasons why women prefer caesarean section and gynecology obstetric clinics doing it was significant (p < 0.05). Statistically significant difference was found between finding the right of abortion and having abortion (p < 0.05). Conclusions: Participating women on average have had a normal birth and once a cesarean delivery, and at least 3 women around each woman seem to have had a cesarean delivery. One of every two females seems to have had an abortion. Effective family planning training should be provided.

Journal of the American Board of Family Medicine : JABFM

Purpose: To examine urban, inner-city female patients' acceptability of the provision of early abortion services by their family physician in the family medicine clinic (FMC).

Obstetrics & Gynecology, 1999

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Perspectives on Sexual and Reproductive Health, 2012

Various restrictions on abortion have been imposed under the pretense that women may be uninformed, undecided or coerced in regard to their decision to terminate a pregnancy. Understanding whether certain women are at risk of low confi dence in their abortion decision is useful for providing client-centered care and allocating counseling time to women with the greatest needs. METHODS: Data were abstracted from the precounseling needs assessment form and clinical intake form of 5,109 women who sought 5,387 abortions at one U.S. clinic in 2008. Multivariate logistic regression was used to analyze variables associated with women's high confi dence in their abortion decision. RESULTS: For 87% of the abortions sought, women had high confi dence in their decision before receiving counseling. Certain variables were negatively associated with abortions' being sought by women with high confi dence: being younger than 20, being black, not having a high school diploma, having a history of depression, having a fetus with an anomaly, having general diffi culty making decisions, having spiritual concerns, believing that abortion is killing and fearing not being forgiven by God (odds ratios, 0.2-0.8). Having a supportive mother or male partner was associated with increased odds of high confi dence (1.3 and 1.2, respectively). CONCLUSIONS: Regulations requiring state-approved information or waiting periods may not meet the complex needs of all women. Instead, women may benefi t more from interactions with trained staff who can assess and respond to their individual needs.

The European Journal of Public Health, 2004

Background: With an incidence of 15‰, abortion is a common reproductive event in France. Thi s study describes conditions of access to health care for abortions based on women's reports, taking into account the woman's background and the influence of the first professional contacted. Methods: A representative sample of 2,863 women, aged 18 to 44, was interviewed by telephone between September 2000 and January 2001. Of these women, 480 had an abortion in the last 10 years. Main results: The choice of first professional depended on women's background, as we found differences according to age, educational level or past induced abortion. This choice affected subsequent access conditions, in terms of time delay or complexity of patterns of care to access abortion services. Women who first contacted a private gynaecologist, which is the most frequent situation in France, had more direct and shorter patterns of care. Conversely, general practitioners were associated with longer and more indirect patterns of care, especially when women were less well educated. Conclusion: This study reveals the heterogeneous nature of patterns of access to an abortion in France. It also raises questions concerning the training of general practitioners, who seem to be less well prepared to take charge of a request for an abortion than other professionals. Efforts must be made to better inform women and these professionals about the process required for abortions.

1995

The European Journal of Contraception & Reproductive Health Care, 2019

Objectives: In Slovenia, first-trimester abortion is performed at the woman's request, either surgically under general anaesthesia or medically with mifepristone and misoprostol, in a public hospital. Our study aimed to evaluate pre-abortion counselling and to reveal differences in acceptability and satisfaction with the two abortion methods. Methods: A cross-sectional study was carried out at Ljubljana University Medical Centre between January and June 2015. Women requesting termination of a pregnancy up to 10 weeks' gestation voluntarily completed an anonymous questionnaire after the procedure and were divided into a surgical and a medical abortion group. Results: Of the 266 women who were invited to take part, 229 accepted; 16.6% chose a surgical abortion, 83.4% a medical abortion. The most frequent reason cited for requesting an abortion was economic/housing problems. Most women who chose a surgical abortion did so because it was faster, whereas most women who chose a medical abortion did so on the advice of a primary care gynaecologist. Women choosing a surgical abortion had more previous pregnancies and presented with a higher gestational age pregnancy. The choice of method was not related to the woman's age. There were no differences in acceptability of the two procedures. Pain during the procedure was, however, more severe in the medical abortion group (p ¼ .026), along with bleeding, nausea and chills; there were no differences in severity of vomiting, diarrhoea, dizziness or headache between the groups. Women in the surgical abortion group reported higher satisfaction with the method (p < .001). The study revealed a low frequency of pre-abortion contraceptive counselling. Conclusion: The most common reason given for choosing a surgical abortion was the speed of the procedure; for a medical abortion, it was on the advice of a primary care gynaecologist. Satisfaction was higher with the surgical abortion method. There were no differences in general acceptability of the methods.

Reproductive health matters, 2010

In the Netherlands, most abortions of early pregnancies have been with electric vacuum aspiration (VA). A study was conducted on women&#39;s motivations for choosing surgical (VA) or medical abortion and extent of satisfaction with the method chosen. Information was also collected about the proportion of medical abortions to total abortions in the Netherlands and, for comparison, in some other European countries. Of 501 women with early abortions surveyed in 2008/09, 71% opted for VA. Except for &quot;previous experience&quot;, women had different motivations for preferring one or other method. At the post-abortion check-up, satisfaction with the medical method was lower compared to VA. Nevertheless, 80% of those who chose medical abortion would do so again. Nineteen out of 20 doctors questioned at a meeting on abortion offered surgical and medical abortion. Seven of the 11 who gave an opinion found medical abortion an excellent alternative and four thought having the choice was imp...