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Objectives
To evaluate the role of the primary obstetrician in abortion experiences of patients
with lethal or life-limiting fetal diagnoses in hostile settings.
Methods
We conducted a qualitative study of Texas patients with lethal or life-limiting fetal
diagnoses using semi-structured interviews. We purposively explored the role of the
primary obstetrician through questions related to fetal diagnosis, pregnancy options
counseling, abortion decision making, and post-abortion reflections. Two researchers
coded all transcripts using an inductive technique and analyzed themes with an iterative
approach.
Results
We interviewed 18 participants who reported gestational ages at the time of abortion
from 13 to 29 weeks. Participants identified the primary obstetrician as a key relationship
during their obstetric and abortion care. This central theme was supported by three
sub-themes: 1) participants desired reiteration or confirmation of information they
received from a specialist; 2) participants wanted information about what to expect
during and after an abortion from a trusted source; and 3) participants noted the
benefit of having post-abortion follow-up to assess psychosocial concerns and future
family planning needs, especially after obtaining an abortion out of state.
Conclusions
Patients seeking abortion care for fetal diagnoses in a hostile setting view the primary
obstetrician as central to their experience. As fetal diagnosis and abortion are often
performed by different specialists in separate locations, primary obstetricians have
the potential to provide continuity of care before and after an abortion and bridge
the gaps in care created by abortion restrictions. Family planning specialists should
facilitate this process by forming relationships with and providing resources for
referring obstetricians.
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Copyright
© 2022 Published by Elsevier Inc.
