A comparison of patient choice of termination of pregnancy procedures
Research type
Research Study
Full title
A comparison of patient choice of termination of pregnancy procedures: The potential impact of different procedures and satisfaction with care provided.
IRAS ID
178126
Contact name
Joanne Fletcher
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 4 months, 2 days
Research summary
Summary of Research
Slade et al. (1998) investigated factors influencing patient choice, the emotional impact and satisfaction with care of women having a general anaesthetic surgical termination of pregnancy (SToP) or a medical ToP (MToP). Generally, women said they would choose the same method again. When they did change their hypothetical choice, it was for a local anaesthetic (LASToP), rather than MToP.Women considered having a choice of ToP important, but exercising choice was not associated with any significant differences in emotional status, before or after termination, or satisfaction with care. Since then, Sheffield Teaching Hospitals NHS FT’s ToP Service has implemented the option of a LASToP, as well as the option of completing an early medical abortion at home. This study aims to investigate the choices women make in relation to ToP, the emotional impact and consequent satisfaction with care. The objectives are to investigate: 1) choice in ToP procedure, 2) factors influencing the type of procedure chosen, 3) the effect of choice on emotional responses, and 4) patient satisfaction with care.
We aim to recruit 120 women (30 in each ToP group) who will complete a semi-structured pre-ToP interview and questionnaire battery with a research assistant. A post-ToP questionnaire pack will be disseminated by post, four weeks after the ToP. Inclusion criteria: Women, at least 16 years of age, experiencing a first or second trimester termination of pregnancy. Exclusion criteria: Where the termination is carried out due to abnormality, or where the pregnancy has occurred because of an assault.
This work will provide robust empirical evidence on which to base advice/offer choice so that staff can better understand the patient experience and adapt their support/advice to women’s needs. Patients will also benefit in having access to staff who can advise with more authority about the suitability of an intervention, thereby personalising patient care.
Summary of Results
This study aimed to ascertain whether women having different Termination of Pregnancy (TOP) procedures differed in their emotional distress before or after the procedure.
The study also aimed to evaluate whether women reported that they were able to choose their preferred TOP procedure, what factors influence a woman’s decision to choose a particular procedure, and whether the perception of having a choice impacts upon their emotional response following the TOP and their satisfaction with the care they received.
The study found that pre- termination of pregnancy emotion-based factors did not differ between groups. Most women felt that they were able to choose their preferred method of TOP. Their decisions were based on factors categorised as procedure-related, lifestyle or social circumstance-related, emotional, or other factors. When no choice was perceived, common reasons reported were that: (1) gestation was too far along for there to be another option, or (2) an appointment was not available within the required timeframe. When women felt that the method of TOP performed was not their choice they found the procedure more stressful. All women reported high satisfaction with care.
Conclusion: A better understanding of the patient experience can inform service development, enabling staff to ensure that the services provided meet women’s needs. The perception that one is able to choose their preferred TOP procedure is important for reducing procedure-related stress and ensuring high satisfaction with care.REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
15/YH/0345
Date of REC Opinion
7 Sep 2015
REC opinion
Further Information Favourable Opinion