Citation

Purcell C, Riddell J, Brown A, Cameron S, Melville C, Flett G, Bhushan Y, McDaid L. BJOG 2017; 124(13): 1983-1992.

Affiliation

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB.

Copyright

(Copyright © 2017, John Wiley and Sons)

DOI

10.1111/1471-0528.14940

PMID

28922538

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'. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

Termination of pregnancy (TOP); abortion stigma; health services; intimate partner violence (IPV); mixed methods; repeat abortion