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.
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.