Evaluating quality of verbal information provision about abortion methods during assessment consultations

Evaluating quality of verbal information provision about

abortion methods during assessment consultations

S.S.M. Wong (1), H.L. Bekker (2), J. Thornton (3), B.A.

Gbolade (1)

Fertility Control Unit, St. James’s University Hospital,

Leeds, UK (1); Academic Unit of Psychiatry and Behavioural Sciences, University

of Leeds, UK (2); Department of Obstetrics and Gynaecology, University of

Nottingham, UK (3)

Introduction: Prior evidence suggests that women

requesting induced abortion, often do not receive adequate written information

to enable them to make informed decisions about undergoing medical or surgical

abortion. Very few studies have assessed the content of consultations about

choice of abortion method. It remains unclear whether the information provided

during assessment consultations is sufficient to enable these women to make

informed decisions about the abortion procedure to have.

Aims & Methods: To evaluate the quality of verbal

information about methods of induced abortion provided by clinicians during

assessment consultations. A sample of 23 consecutive assessment consultations

for induced abortion under nine weeks gestation in a UK teaching hospital’s

fertility control clinic were audio tape-recorded. The consultation transcripts

were analysed using a coding frame developed from the data and literature on

informed decision to assess adequacy of information provided about the benefits,

risks and aftercare of both abortion methods.

Results: Clinicians provided sufficient information about

the medical procedure but less comprehensive information about the surgical

procedure. None of the consultations provided complete information about the

risks of both methods. When risks were communicated, verbal expressions (e.g.

quite rare) were used rather than presentation of the actual risk figure (e.g.

1%). Inadequate information about aftercare was often provided. All clinicians

undertaking the consultations made it clear to the women that the decision

regarding which method of abortion to undergo was entirely within the women’s

domain. In general, women choosing to have medical abortion received more

information about the medical method, while those choosing the surgical method

received more information on the surgical method.

Conclusions: Women appeared to have received reasonable

verbal information about both methods of induced abortion but communication of

risk and aftercare information was inadequate. It is unclear whether the final

choice was dependent on which method was given more emphasis by the clinicians

or whether the women made their choice prior to the consultation and more

discussion was offered on the chosen method. Either way, this study suggests

that the content of consultations do not compensate for the limitations of

incomplete written information suggested by previous studies. Further research

is required to improve information provision in order to facilitate women’s

informed decision making about abortion methods.

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