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

TY - JOUR

T1 - Women's experiences of more than one termination of pregnancy within two years

T2 - A mixed-methods study

AU - Purcell, C.

AU - Riddell, J.

AU - Brown, A.

AU - Cameron, S. T.

AU - Melville, Craig

AU - Flett, Gillian

AU - Bhushan, Y.

AU - McDaid, Lisa M.

N1 - Funding; Scottish Government; UK Medical Research Council (MRC); Scottish Government Chief Scientist Office (CSO) at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow (Grant Numbers: MC_UU_12017/2, MC_UU_12017/11, SPHSU11).

PY - 2017/11/22

Y1 - 2017/11/22

N2 - 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'.

AB - 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'.

KW - Abortion stigma

KW - Health services

KW - Intimate partner violence

KW - Mixed methods

KW - Repeat abortion

KW - Termination of pregnancy

U2 - 10.1111/1471-0528.14940

DO - 10.1111/1471-0528.14940

M3 - Article

C2 - 28922538

AN - SCOPUS:85031717202

SN - 1470-0328

VL - 124

SP - 1983

EP - 1992

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

IS - 13

ER -