How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress

Abstract

Objectives To identify perceived deficiencies in the quality of abortion care among healthy women and those with mental stress.

Methods This multi-centre cohort study included six obstetrics and gynaecology departments in Sweden. Posttraumatic stress (PTSD/PTSS) was assessed using the Screen Questionnaire-Posttraumatic Stress Disorder; anxiety and depressive symptoms, using the Hospital Anxiety Depression Scale; and abortion quality perceptions, using a modified version of the Quality from the Patient's Perspective questionnaire. Pain during medical abortion was assessed in a subsample using a visual analogue scale.

Results Overall, 16% of the participants assessed the abortion care as being deficient, and 22% experienced intense pain during medical abortion. Women with PTSD/PTSS more often perceived the abortion care as deficient overall and differed from healthy women in reports of deficiencies in support, respectful treatment, opportunities for privacy and rest, and availability of support from a significant person during the procedure. There was a marginally significant difference between PTSD/PTSS and the comparison group for insufficient pain alleviation.

Conclusions Women with PTSD/PTSS perceived abortion care to be deficient more often than did healthy women. These women do require extra support, relatively simple efforts to provide adequate pain alleviation, support and privacy during abortion may improve abortion care.

Chinese Abstract

摘要：

目的：了解健康女性和精神紧张女性对流产服务质量的不足的认知。

方法：这是一项由瑞典6个妇产科参加的多中心队列研究。创伤后应激(PTSD/PTSS)由创伤后应激障碍筛查问卷来评价。焦虑和抑郁症状，用医院焦虑和抑郁量表来评价。对流产服务质量的认知用修改版的从病人角度的质量问卷来评价。流产过程中疼痛用视觉模拟评分法来评价。

结果：所有受试者中，16%的人认为流产服务有缺陷，药物流产过程中，22%的人疼痛剧烈。

和健康女性不同，有创伤后应激障碍（PTSD/PTSS）的女性认为流产服务整体不足，健康女性则认为在某些方面存在不足，如获得支持、得到尊重、有独处和休息的机会、过程中得到重要的人的支持的可能性等方面。在有效镇痛的不足上，PTSD/PTSS组和对照组的看法有轻微差异。

结论：有创伤后应激障碍（PTSD/PTSS）女性比健康女性更经常认为流产服务有缺陷，这些女性需要额外的支持，需要相对简单的措施来提供足够的镇痛，流产过程中的支持和私密能促进流产服务。

Keywords:

• Abortion
• Ambulatory care facilities
• Stress disorders
• Posttraumatic stress disorders
• Anxiety
• Depression

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding for this project was provided by the Marianne and Marcus Wallenberg Foundation, the Medical Faculty of Uppsala Universities, the Family Planning Foundation at Uppsala University, the Regional Research Committees of Uppsala and Örebro Counties Councils and Sophiahemmet Foundation.