Home abortion. Experiences of women and their partners
Marianne Wulff, Anneli Kero, Katarina Bergström, Ann Lalos (Sweden)
Department of Clinical sciences, obstetrics and gynecology, Umeå University, 901 87 Umeå, Sweden
Background.At Umeå university hospital in Sweden 34% (2007) of all medical abortions were homeabortions. A team of counsellor, nurse as well as a gynaecologist will take care of the abortion seeking woman/couple and offer the opportunity to choose between medical abortion (when early in pregnancy) or surgical abortion. If medical abortion is preferred by the woman, she can do it at home if she wants to and if she fulfils certain criteria (not being too young or immature, not suffering from heavy dysmenorrhoea, not being alone at the time for abortion and not living too far from the hospital). The aim of the study was to gain deeper knowledge about experiences, opinions and reactions among women who choose homeabortions and among their partners present when the abortion took place.
Subjects and methods.Telephone interview by the counsellor in the abortion team using a semi-structured questionnaire with 41 questions, most of these being open-ended. Interviewed were: 100 women and 25 partners. Most women were interviewed one week after the abortion. Quantitative data were analysed using SPSS -programme and the open-ended qualitative data were analyzed using content analysis.
Results.The mean age was 32 years and the majority was married or cohabiting. Pregnant for the first time were 18 women and almost half (45) had had an abortion earlier. The women wanted to do the abortion at home because of a wish of: “control and integrity”, “not having to respond to other people”, “becoming more peaceful when in your own environment”, “not making the process so dramatic”. The overall experience of the homeabortion was that it was “as expected or easier than expected”. The day of mifepristone however, was for many women filled of strong emotions, often paradoxical feelings, and a waiting to the day of prostaglandin and the expulsion of the fetus. That day were dominated by physical symptoms such as nausea, pain and bleeding. Women expressed with emphasis that they would recommend homeabortion to other women. Regarding the partners present during the day of the abortion, they were present because: “it felt natural” or “because she asked for it . Theirreflexions included feelings of “contribution”, “involvement” and “I had a greater role than I would have had at the hospital”.
Conclusions.When having the opportunity to choose homeabortions, the vast majority of women 26-45 years who chose this type of care felt healthier, freer and more empowered having done the abortion at home. They experienced the abortion “as expected or easier than expected” and would strongly recommend it to other women. Their partners were satisfied too, mostly due to the opportunity to be involved to a greater extent than if being at the hospital.