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Original research
Client perspectives on choice of abortion method in England and Wales
  1. Rebecca Blaylock1,
  2. Shelly Makleff2,
  3. Katherine C Whitehouse1,
  4. Patricia A Lohr1
  1. 1 Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK
  2. 2 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Rebecca Blaylock, Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, EC4A 1JQ, UK; rebecca.blaylock{at}bpas.org

Abstract

Introduction The National Institute for Health and Care Excellence, the Royal College of Obstetricians and Gynaecologists and the World Health Organization recommend that services provide a choice between medical and surgical methods of abortion. We analysed qualitative study data to examine patient perspectives on abortion method choice and barriers to meeting them.

Methods In-depth interviews with 24 clients who had an abortion at British Pregnancy Advisory Service clinics were carried out between December 2018 and July 2019 to examine perspectives of quality of abortion care. In this article we focus on client perspectives on choice of abortion method. We performed thematic analysis of data relating to choice of abortion method, refined the analysis, interpreted the findings, and organised the data into themes.

Results Participants’ preferences for abortion method were shaped by prior experience of abortion, accessibility and privacy, perceptions of risk and experiences of abortion method, and information gathering and counselling. Participants’ ability to obtain their preferred method was impacted by intersecting constraints such as appointment availability, service location and gestational age.

Conclusions Our findings show that many factors shape participants’ preferences for abortion method. In response to the COVID-19 pandemic, some abortion services have constrained abortion method choices, with an emphasis on medical abortion and ‘no-touch’ care. Providers in the UK and beyond should aim to restore and expand more treatment options when the situation allows.

  • abortion
  • induced
  • COVID-19
  • family planning services
  • patient preference
  • reproductive health
  • qualitative research

Data availability statement

Data are available upon reasonable request. The researchers used deidentified participant data. More information can be sought from the team via research@bpas.org.

https://doi.org/10.1136/bmjsrh-2021-201242

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    Data availability statement

    Data are available upon reasonable request. The researchers used deidentified participant data. More information can be sought from the team via research@bpas.org.

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    Footnotes

    • Contributors KW, PAL, SM: designed the study protocol and interview guide. RB, PAL: conducted interviews with participants. RB, SM, KW, PAL: analysed and interpreted the qualitative interviews. RB: took the lead in writing the manuscript. PAL, KW, SM: revised the manuscript. All authors read and approved the final manuscript.

    • Funding The funding for this research was provided internally at BPAS.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.