Abortion doula impact on first trimester abortion pain
Awarded 2012
Junior Investigator Grants
Julie Chor, MD, MPH
University of Chicago

Background: The involvement of a lay support person, known as a doula, during obstetric care is associated with positive outcomes including decreased analgesic need and obstetric interventions. The full spectrum doula is a model in which doulas support women throughout their reproductive experiences, including birth, miscarriage, adoption, and abortion. Objectives: Primary objective is to assess the effect of abortion doula support on the pain at the time of a first trimester abortion, as measured using a 100-mm Visual Analog Scale (VAS). Secondary objectives are to assess the impact of doula involvement on patient satisfaction, provider assessment of procedure difficulty, procedure time, and patient interest in becoming an abortion doula. Design and Methodology: This is a non-blinded randomized trial randomizing 220 women to doula support by a trained abortion doula or to have a staff member unfamiliar with doula techniques present in the room during the procedure. Sample size was calculated to obtain 80% power with an alpha of 0.05 using the assumption that 50% of participants not receiving doula support and 30% of participants receiving doula support will have a pain score above a previously reported mean abortion pain score of 55mm on a 100-mm VAS. Rationale: We have introduced an abortion doula program at the John H. Stroger, Jr. Hospital of Cook County with positive responses from patients and clinic staff. In light of the demonstrated benefits of doula support in obstetric care, we seek to conduct the first systematic evaluation of the benefits of doula support in abortion care.