Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics

Abstract

We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed.

Keywords:

• medical abortion
• women's perspectives
• India

Acknowledgements

The study was funded by a grant from the Hewlett foundation to the Population Council. Ipas received a sub-award from the Population Council to collaborate on this study. The study was carried out by Ipas and the Population Council in partnership with KEM Hospital in Pune and Parivar Seva Sanstha in Delhi. The authors are grateful for the contributions of Savita Kanade, Shubha Ambardekar, Shalini Verma, Abhijeet Anand, Tina Bhalla and Alok Banerjee. We also thank Shireen Jejeebhoy, Traci Baird and Janie Benson for reviewing earlier drafts of this paper.