What constitutes a meaningful abortion experience: Women’s perspectives
Abortion
Awarded 2014
Complex Family Planning Fellowship Research
Anna Altshuler, MD, MPH
Stanford University School of Medicine
$40,646

Background
Ending a pregnancy is a significant event in a woman’s life, as well as in the lives of her partner, family, and community. In the United States, how women experience abortion has been shaped by sociopolitical processes, medical paradigms, and the Feminist Movement, and less so by women who receive this care. As abortion provision becomes integrated into mainstream medicine, it is important to incorporate women’s preferences into determining how we provide abortions. Most studies in the US examining abortion experiences were conducted in the context of mifepristone-based medication abortion clinical trials on homogenous populations, focused on comparing preferences between medication and surgical abortion and tested specific hypotheses with respect to abortion care. There are no studies that have explicitly elicited patients’ perspectives regarding what abortion care should be like.
 
Objectives
The aim is to generate hypotheses regarding what constitutes a meaningful abortion experience and how structural aspects of abortion such as preparation for the abortion, method of abortion, type of provider and support during the abortion influence women’s contentment with the process. This analysis will yield a theoretical framework comprised of thematic domains that will help explain what constitutes a meaningful abortion experience and why.
 
Methods
This study will be conducted through in-person semi-structured in-depth interviews yielding data to be analyzed using qualitative methods including grounded theory and predetermined codes based on our literature review. Participants will be asked to summarize all of their reproductive experiences and to specifically discuss a memorable birth, with a particular focus on what was good and bad about it and why. Next they will be asked to talk about an abortion in the same fashion. Then participants will describe a hypothetical abortion based on what they value. Lastly, they will complete a validated Individual Level Abortion Stigma Scale and demographic questions to better characterize our study population. This quantitative data will be analyzed using descriptive statistics.
 
Participants will be recruited from community colleges, WIC office, public libraries and Craigslist in Oakland, California. Inclusion criteria are: female gender, 18-40 years old, having had a prior birth and abortion in the United States, English speaking, and having the potential of being pregnant in the future. This study is projected to run for 12 months, with the goal of completing and analyzing 25 interviews.
 
Anticipated Outcomes
Theoretical framework to understand what women value in abortion care to inform abortion provision.

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