PLoS One 2014 Dec 29;9(12):e115957. doi: 10.1371/journal.pone.0115957. eCollection 2014

Experiences, feelings and thoughts of women undergoing second trimester medical termination of pregnancy

Andersson IM, Christensson K and Gemzell-Danielsson K


Main objective: The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion.

Methods: This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis.

Most important findings: Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion.

Conclusions: The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective of the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the indication is for the abortion.

Comment: This study from Sweden shows how important it is that the staff who help women with a second trimester abortion, are well trained in dealing with the emotional aspects. (HMV)