Self-management of first trimester medical termination of pregnancy: a qualitative study of women's experiences

Purcell, C. , Cameron, S., Lawton, J., Glasier, A. and Harden, J. (2017) Self-management of first trimester medical termination of pregnancy: a qualitative study of women's experiences. BJOG: An International Journal of Obstetrics and Gynaecology, 124(13), pp. 2001-2008. (doi: 10.1111/1471-0528.14690) (PMID:28421651) (PMCID:PMC5724679)

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Objective: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. Design: Qualitative interview study. Setting: One National Health Service health board (administrative) area in Scotland. Population or Sample: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014. Methods: In-depth, semi-structured interviews with 44 women in Scotland who had recently undergone TOP ≤63 days of gestation, and who returned home to pass the pregnancy. Data were analysed thematically using an approach informed by the Framework method. Main Outcome Measures: Women's experiences of self-management of TOP ≤63 days of gestation. Results: Key themes emerging from the analysis related to self-administration of misoprostol in clinic; reasons for choosing home self-management; facilitation of self-management and expectation-setting; experiences of getting home; self-managing and monitoring treatment progress; support for self-management (in person and remotely); and pregnancy self-testing to confirm completion. Conclusions: Participants primarily found self-administration of misoprostol and home self-management to be acceptable and/or preferable, particularly where this was experienced as a decision made jointly with health professionals. The way in which home self-management is presented to women at clinic requires ongoing attention. Women could benefit from the option of home administration of misoprostol.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Purcell, Dr Carrie
Authors: Purcell, C., Cameron, S., Lawton, J., Glasier, A., and Harden, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:BJOG: An International Journal of Obstetrics and Gynaecology
ISSN (Online):1471-0528
Published Online:19 April 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BJOG: An International Journal of Obstetrics and Gynaecology 124(13):2001–2008
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727631SPHSU Core Renewal: Relationships & Health Improvement Research ProgrammeLisa McDaidMedical Research Council (MRC)MC_UU_12017/11IHW - MRC/CSO SPHU