A review of termination of pregnancy: prevalent health care professional attitudes and ways of influencing them (original) (raw)
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Termination of pregnancy: Patients' perceptions of care
Journal of Family Planning and Reproductive Health Care, 2001
Background. Little is known about women's perceptions of care in termination of pregnancy (TOP). Developing an understanding of how care is experienced is crucial to improvements in services. Method. Two hundred and eight women undergoing either a medical or surgical TOP reported on their perspectives of the experience and the care received. A mix of questionnaire and open questions analysed by content analysis was used. Women reported on the aspects which were most stressful, helped them to feel more relaxed, were unexpected in some way, and also on the provision of information and on the quality of staff care. Results. The most stressful aspects for the medical group related to the physical and emotional aspects of the process, whilst for the surgical group it concerned waiting in hospital for the operation. Whilst little was unexpected for the surgical group, many aspects came as a surprise to the medical group. Seeing the foetus was particularly difficult. All information provided was viewed as helpful, with greater information required about the phase following termination. Care from staff was rated positively, although areas for improvement in terms of opportunity to ask questions and ensuring concerns were dealt with were identified. Caring and non-judgemental staff attitudes were viewed as particularly important in helping women to feel as relaxed as possible in a potentially stressful situation. Conclusion: Surgical termination schedules should avoid a long waiting time once the woman has been admitted. More adequate preparation is required for those having medical termination so that they have realistic expectations of what will happen, including the possibility of seeing the foetus. More attention to information about the time following termination, including possible emotional responses, is needed. The importance of positive staff attitudes in the quality of care is emphasised.
A review of developments in medical termination of pregnancy
Journal of Clinical Nursing, 2008
A review of developments in medical termination of pregnancy Aim. This literature review aims to supplement guidelines by providing an overview of recent evidence relevant to medical termination of pregnancy. Background. Termination of pregnancy is available to women in the UK within legal parameters. Although guidelines form a strong body of evidence on which nurses and midwives can base their practice, there is a need to supplement them with up-to-date robust research findings. Method. A systematic search of the literature with high sensitivity and low specificity was undertaken on five databases using medical subject headings (MeSH) terms including (medical) induced abortion, therapeutic abortion and termination of pregnancy. Results. The literature search revealed articles under the following headings: The importance of choice for the women involved the need for the optimal medication type, dose, route and interval between stages one and two, and the optimum place for medical termination to take place. Conclusion. It was found that women attach a great deal of importance to the opportunity to choose their method of termination. The first stage of mifepristone is now a standard practice and an optimum dose has been determined. Several studies examined misoprostol used in the second stage of medical termination. There was some evidence for repeated doses of misoprostol, particularly in later gestation, with conflicting evidence on the optimal route. There were some grounds for reducing the interval between stages. Consideration should be given to home medical termination based on individual circumstances and choice. Gestation and previous obstetric history is an important factor to take into account when determining optimal regimen. Relevance to clinical practice. The number of medical termination of pregnancies performed has risen in recent years together with the nurses' involvement. As new research is published, it is imperative that nurses adapt to base their involvement on the best available evidence.
Women’s experiences and acceptability of medical termination of pregnancy
Journal of Health Research
Purpose The purpose of this paper is to understand women’s experiences, acceptability and outcomes of using the medical termination of pregnancy (MTP). The study is conducted at nine reproductive health and family planning clinics at university hospitals as well as regional and provincial hospitals located in Bangkok and the locations within Thailand. Design/methodology/approach This is a descriptive research recruiting healthy women with pregnancy up to 63 days since the last menstrual period (LMP) who opted for MTP during 2012–2014. Findings A total of 443 women who were referred from the reproductive health networks voluntarily participated in the study. Overall, 92.6 percent of participants had a complete abortion. No serious adverse events were found for cases using misoprostol at home or at clinic. More than 98.3 percent of the women felt satisfied or very satisfied with the method. More than 80 percent of participants thought that the side-effects of the method were as expect...
Termination of pregnancy services: experiences of gynaecological nurses
Journal of Advanced Nursing, 2010
nicholson j., slade p. & fletcher j. (2010) Termination of pregnancy services: experiences of gynaecological nurses. Journal of Advanced Nursing 66(10), 2245–2256.Aim. This paper is a report of a study to identify the experience of gynaecological nurses involved with termination of pregnancy.Background. Staff involved with termination of pregnancy have been found to experience both positive and negative views. Varying processes and experiences for staff have been identified, from termination of pregnancy work being emotionally draining and stressful to there being a process of care that evolves with greater experience.Methods. A purposive sample of seven gynaecological nurses currently working in a termination of pregnancy service was recruited. Data were collected between October 2007 and January 2008 using interviews and standardized questionnaires. Transcripts of the interviews were analysed using Interpretive Phenomenological Analysis.Results. Eight superordinate themes emer...
The experience of Italian nurses and midwives in the termination of pregnancy: a qualitative study
The European Journal of Contraception & Reproductive Health Care, 2017
Objectives: The aim of the study was to provide insight into the experiences of nurses and midwives working in the Italian abortion service. Methods: Study participants were recruited through purposive sampling. Semi-structured interviews were conducted between July and September 2016, among 22 nurses and two midwives working in five abortion services in Milan, Italy. Transcripts of interviews were analysed using a phenomenological approach to data analysis. Results: Five main themes emerged from the analysis: (a) coping with caring for women undergoing a termination of pregnancy; (b) improving professional training; (c) approaching work in a mechanistic way as a means of overcoming difficulties; (4) performing medical abortions; (d) recounting an experience. Conclusions: This first study about assisting with pregnancy termination in Italy may enable critical comparison with studies carried out in other countries. Both nurses and midwives suggested strategies, which may improve the provision of care: collaboration between primary and tertiary care, continuous training, multidisciplinary collaboration, increase of staff turnover and being kept abreast of new pharmaceutical products. Our findings are applicable to wider medical practice.
British journal of obstetrics and gynaecology, 1998
To investigate whether women having medical or surgical terminations of pregnancy differ in their emotional distress before or after the procedure. To evaluate whether choice of procedure occurs, the factors influencing type of procedure and the effect of choice on emotional responses and satisfaction with care. A prospective comparative study. A termination of pregnancy unit in a University Teaching Hospital. Two hundred and seventy-five women attending for medical or surgical first trimester termination of pregnancy. Interviews concerning choice and measures of emotional status were completed prior to terminations. Four weeks after termination emotional functioning was reassessed together with satisfaction with care. Women having a surgical termination waited longer for the procedure and were at more advanced gestation than those having the medical termination. There were no differences in emotional responses related to type of procedure or gestation. One-quarter remained highly a...
BMC Public Health, 2009
Background: Despite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning.
Negah Institute for Social Research & Scientific Communication, 2021
Background: Despite the implementation of a safe motherhood program in many countries, unsafe abortion continues to be a matter of reproductive health. Thus, urgent efforts to make abortion legal and safe have been recommended in developing countries. The present study was done to determine the knowledge of midwives and obstetricians about the therapeutic abortion law as well as their attitude about the ethical pitfalls. Methods: In this descriptive knowledge and attitude study, a researcher-made questionnaire was used to gather data, after estimating the appropriate Cronbach's Alpha coefficient. A total of 162 midwives and obstetricians working in public and private medical centers affiliated to Shahid Beheshti University of Medical Sciences in 2018 were included in the study by convenience sampling method. Results: According to the results, 9.3% of participants had a low level, 72.8% had a moderate level, and only 17.9% had a good level of knowledge. The total mean score of knowledge was 7.17±1.7. The mean score of knowledge in the group of obstetricians (7.60±1.74) was significantly higher than midwives (6.94±1.54), (t=2.29, P=0.024). There was a significant correlation between participants' age and their knowledge (r=0.912, P=0.001). Also, 47.53% of the participants believed that the therapeutic abortion law has some pitfalls. The most frequent attitude was about the restriction of the therapeutic law up to 19 weeks for fetal indications. Conclusion: The level of participants' knowledge was low to moderate. The findings indicated the need for training the professional standards related to prenatal genetic screening and therapeutic abortion.