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Women’s experiences of self-referral to an abortion service: qualitative study
  1. Shin Thong Low1,
  2. Zhong Eric Chen2,
  3. Sharon Cameron2,3
  1. 1 The University of Edinburgh Edinburgh Medical School, Edinburgh, UK
  2. 2 Clinical Effectiveness Unit of the FSRH, Chalmers Centre, Edinburgh, UK
  3. 3 Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK
  1. Correspondence to Shin Thong Low, The University of Edinburgh Edinburgh Medical School, Edinburgh EH16 4TJ, UK; s1605448{at}


Background Guidelines from the UK recommend that women should be able to self-refer to abortion services. In 2016, a self-referral system was introduced to the abortion service in Edinburgh, Scotland, as an option for women. Women could telephone a dedicated phone line during office hours and speak to an administrative assistant working in the abortion service who provided them the next available appointment to be seen in the service. This study aimed to evaluate a self-referral service to abortion by investigating its impact on women’s experiences of the referral process.

Methodology 21 semistructured interviews of women attending a specialist abortion service in Edinburgh, Scotland, were conducted. Interviews were transcribed verbatim and thematically analysed. The interviews focused on women’s experience of the referral process.

Results Three main themes arose from the interviews, including reasons for choosing self-referral, experience of self-referral and challenges to using self-referral. Reasons for choosing self-referral were related to convenience, privacy and autonomy. Women found the experience of self-referral to be pleasant, non-judgemental and patient-centred, and self-referral prepared them for the appointment at the specialist abortion service. However, some women felt rushed, and self-referral made them anxious to attend the appointment. Challenges were difficulty with getting through on telephone lines, varying levels of support required for different individuals and awareness about the option of self-referral.

Conclusion Women valued the option of self-referral. Women felt that the service should be expanded to increase availability,and promoted to women more widely within the community .

  • abortion
  • qualitative research
  • service delivery

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  • Contributors STL designed and carried out interviews, transcribed and analysed the data, and drafted and revised the paper. ZEC designed the interviews and revised the paper. SC initiated the project and revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • 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.

  • Patient consent for publication Not required.

  • Ethics approval This study was considered a health service evaluation and did not require NHS ethical approval under advice sought from the Scientific Officer of South East Scotland NHS Research Ethics Committee. Management approval was gained from the local NHS Quality Improvement Team.

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

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study. No data are available. No data are available.