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

Purcell, C. , Riddell, J. , Brown, A., Cameron, S., Melville, C., Flett, G., Bhushan, Y. and McDaid, L. (2017) Women's experiences of more than one termination of pregnancy within two years: a mixed-methods study. BJOG: An International Journal of Obstetrics and Gynaecology, 124(13), pp. 1983-1992. (doi:10.1111/1471-0528.14940) (PMID:28922538) (PMCID:PMC5725730)

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Abstract

Objective: To examine the experiences of women seeking more than one termination of pregnancy (TOP) within two 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 two years, beyond two 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 two years, respectively. Previous TOP within two years group was significantly less likely to own their accommodation than no previous TOP group [aOR=0.34, 95% confidence interval (CI) 0.18-0.62] and previous TOP beyond two 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 no previous TOP and previous TOP within two years groups, respectively. Twenty-three women from previous TOP within two years group were interviewed. Qualitative and integrative analyses highlight issues relating to contraceptive challenges, intimate partner violence, life aspirations and socioeconomic disadvantage. Conclusions: Women undergoing more than one TOP within two years may experience particular challenges and vulnerabilities. Service provision should recognise this and move away from stigmatising discourses of ‘repeat abortion’.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Purcell, Dr Carrie and McDaid, Professor Lisa and Riddell, Miss Julie
Authors: Purcell, C., Riddell, J., Brown, A., Cameron, S., Melville, C., Flett, G., Bhushan, Y., and McDaid, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:BJOG: An International Journal of Obstetrics and Gynaecology
Publisher:Wiley
ISSN:1470-0328
ISSN (Online):1471-0528
Published Online:18 September 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BJOG: An International Journal of Obstetrics and Gynaecology 124(13):1983-1992
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
656571Sexual Health and Families ProgrammeLisa McDaidMedical Research Council (MRC)MC_UU_12017/2IHW - MRC/CSO SPHU
727631SPHSU Core Renewal: Relationships & Health Improvement Research ProgrammeLisa McDaidMedical Research Council (MRC)MC_UU_12017/11IHW - MRC/CSO SPHU