Women's experiences of more than one termination of pregnancy within two years: A mixed-methods study

C. Purcell, J. Riddell, A. Brown, S. T. Cameron, Craig Melville, Gillian Flett, Y. Bhushan, Lisa M. McDaid

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    Abstract

    Objective: To examine the experiences of women seeking more than one termination of pregnancy (TOP) within 2 years. Design: Mixed methods study. Setting: Six TOP services across Scotland. Sample: Women presenting for TOP between July and December 2015. Methods: Descriptive and inferential analysis of quantitative survey data, thematic analysis of qualitative interview data and integrative analysis. In quantitative analysis, multinomial logistic regression was used to compare three groups: previous TOP within 2 years, previous TOP beyond 2 years and no previous TOP. Main outcome measures: Characteristics and experiences of women seeking TOP. Results: Of 1662 questionnaire respondents, 14.6% (n = 242) and 19.8% (n = 329) reported previous TOP within and beyond 2 years, respectively. The previous TOP within 2 years group was significantly less likely to own their accommodation than the no previous TOP group (adjusted odds ratio [aOR] 0.34, 95% CI: 0.18-0.62) and previous TOP beyond 2 years group (aOR: 0.44, 95% CI: 0.23-0.85); and more likely to report inconsistent (aOR: 1.63, 95% CI: 1.04-2.57; aOR: 1.95, 95% CI: 1.16-3.28) and consistent (aOR: 2.13, 95% CI: 1.39-3.26; aOR: 1.71, 95% CI: 1.07-2.76) contraceptive use than the no previous TOP and previous TOP within 2 years groups, respectively. Twenty-three women from the previous TOP within 2 years group were interviewed. Qualitative and integrative analyses highlight issues relating to contraceptive challenges, intimate partner violence, life aspirations and socio-economic disadvantage. Conclusions: Women undergoing more than one TOP within 2 years may experience particular challenges and vulnerabilities. Service provision should recognise this and move away from stigmatising discourses of 'repeat abortion'.

    Original languageEnglish
    Pages (from-to)1983-1992
    Number of pages10
    JournalBJOG: An International Journal of Obstetrics & Gynaecology
    Volume124
    Issue number13
    Early online date20 Oct 2017
    DOIs
    Publication statusPublished - 22 Nov 2017

    Keywords

    • Abortion stigma
    • Health services
    • Intimate partner violence
    • Mixed methods
    • Repeat abortion
    • Termination of pregnancy

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    Purcell, C., Riddell, J., Brown, A., Cameron, S. T., Melville, C., Flett, G., Bhushan, Y., & McDaid, L. M. (2017). Women's experiences of more than one termination of pregnancy within two years: A mixed-methods study. BJOG: An International Journal of Obstetrics & Gynaecology, 124(13), 1983-1992. https://doi.org/10.1111/1471-0528.14940