Patient’s experiences of undergoing abortion with and without an ultrasound scan in Britain

Rebecca Blaylock*, Patricia Lohr, Lesley Hoggart, Pam Lowe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Routine ultrasound scanning to determine gestational age and pregnancy location has long been part of pre-abortion assessment in Britain, despite not being legally required or recommended in national clinical guidelines. To support implementation of fully telemedical abortion care (implemented in Britain in April 2020), the Royal College of Obstetricians and Gynaecologists (RCOG) issued clinical guidance for an ‘as-indicated’ approach to preabortion ultrasound, removing the need for a clinic visit. We aimed to understand patient experiences of ultrasound in abortion care by conducting a qualitative study with individuals who had abortions with and without an ultrasound.

Methods: Between November 2021 and July 2022, we recruited patients who had a medical abortion at home without a pre-procedure ultrasound at 69 days’ gestation or less at BPAS, and also had at least one other abortion with an ultrasound from any provider in Britain. We conducted interviews using a semi-structured nterview guide to explore our participants’ experiences and conducted reflexive thematic analysis.

Results: We recruited 24 participants and included 19 interviews in our analysis. We developed three themes from our data. These are ‘ultrasound scans and their relationship with autonomy and decision-making’, ‘intrusive and out of place: the ultrasound as an inappropriate technology’, and ‘towards preference-centred, quality care’.

Conclusions: Further research and user-testing of strategies to improve the scan experience should be undertaken. Patient testimonies on the negative impact of ultrasound scans in abortion care should reassure providers that omitting them according to patient preference is a positive step towards providing patient-centred care.
Original languageEnglish
JournalBMJ Sexual & Reproductive Health
Publication statusAccepted/In press - 5 Feb 2024

Bibliographical note

This article has been accepted for publication in BMJ Sexual & Reproductive Health, 2024, following peer review, and the Version of Record can be accessed online at: [DOI here when available]. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/.

Keywords

  • abortion, induced, qualitative research, Patient Preference

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