Abstract
Objective
To explore how doula support influences women's experiences with first-trimester surgical
abortion.
Study Design
We conducted semistructured interviews with women given the option to receive doula
support during first-trimester surgical abortion in a clinic that uses local anesthesia
and does not routinely allow support people to be present during procedures. Dimensions
explored included (a) reasons women did or did not choose doula support; (b) key aspects
of the doula interaction; and (c) future directions for doula support in abortion
care. Interviews were transcribed, and computer-assisted content analysis was performed;
salient themes are presented.
Results
Thirty women were interviewed: 19 received and 11 did not receive doula support. Reasons
to accept doula support included (a) wanting companionship during the procedure and
(b) being concerned about the procedure. Reasons to decline doula support included
(a) a sense of stoicism and desiring privacy or (b) not wanting to add emotion to
this event. Women who received doula support universally reported positive experiences
with the verbal and physical techniques used by doulas during the procedure, and most
women who declined doula support subsequently regretted not having a doula. Many women
endorsed additional roles for doulas in abortion care, including addressing informational
and emotional needs before and after the procedure.
Conclusion
Women receiving first-trimester surgical abortion in this setting value doula support
at the time of the procedure. This intervention has the potential to be further developed
to help women address pre- and postabortion informational and emotional needs.
Implications
In a setting that does not allow family or friends to be present during the abortion
procedure, women highly valued the presence of trained abortion doulas. This study
speaks to the importance of providing support to women during abortion care. Developing
a volunteer doula service is one approach to addressing this need, especially in clinics
that otherwise do not permit support people in the procedure room or for women who
do not have a support person and desire one.
Keywords
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References
- Continuous support for women during childbirth.Cochrane Database Syst Rev. 2012; 16
- Listening to mothers II: report of the Second National U.S. Survey of Women’s Childbearing Experiences.J Perinat Educ. 2007; 16: 9-14
- Doula support during first-trimester surgical abortion: a randomized controlled trial.Am J Obstet Gynecol. 2015; 212: 45.e1-45.e6
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Article info
Publication history
Published online: October 16, 2015
Accepted:
October 15,
2015
Received in revised form:
October 14,
2015
Received:
June 18,
2015
Footnotes
☆Funding: Research reported in this publication was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR000431. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
☆☆Presentation information: Presented at the American College of Obstetricians and Gynecologist's Annual Clinical Meeting, San Francisco, CA, May 2–6, 2015.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
