Girlfriends were more often involved than relatives and ... one of them withdrew her application for abortion, the other five women underwent abortion. Only.
Scand J Prim Health Care 1986; 4:225-30
Induced Abortion Decision and Need for Medical Information FINN EGIL SKJELDESTAD
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Department of Gynecology and Obstetrics and Department of Community Medicine and General Practice, University of liondheim, Norway
Skjeldestad FE. Induced abortion. Decision and need for medical information. Scand J Prim Health Care 1986; 4 225-30.
This study gives attention to the preabortion encounter: to what extent medical information was provided and to what extent professional health workers took part in the decision-making process concerning abortion. During the first half year of 1983, 405 women demanding abortion at the Gynecological Department, University Hospital of ’Eondheim, Norway were interviewed. Ninety-five per cent of the women had a preabortion visit at a physician’s office. Nearly 44 % of the women were informed about the surgical procedure, while only 26 % of the women were informed about the possible medical risks. Upon arrival at the hospital to have the abortion carried out 5 3 % of the women wanted information about the surgical procedures, while 72 % wanted information about possible medical complications related to the intervention. Fifty-six per cent of the women decided on abortion themselves. Seventy-six per cent (304/405)of the women had discussed termination of the pregnancy with their partners. Of these women 54 9% (164/304) decided on abortion together with their partners. Married women and cohabitants decided more often together with their partners than women living alone did (p~0.01). Only seven per cent of the women who had a preabortion visit discussed the abortion decision with their physician, while less than one per cent of the women decided on abortion during consultation with their physician. At the time of conception over 70% of the women were not using any contraceptives. Among those women who became pregnant as a result of contraceptive failure, significantly more women were either married or cohabitants. The majority of the abortion-seeking women had a pre-abortion visit with a general practitioner. Information on procedures at the hospital and possible medical risks related to the intervention should be provided at the preabortion visit without request from the woman. The primary health care has the possibility for continuing support, therefore primary health care is the place for family planning discussion, pre-post abortion counseling.
Key words: induced abortion, information, counseling, decisions. F.E. Skjeldestad, Department of Gynecology and Obstetrics and Department of Community Medicine and General Practice, University of Trondheim, Norway.
The law of “Induced abortion on woman’s demand” was introduced in Norway, January 1979. According to this law, women seeking abortion are to be given medical as well as social information relevant to the termination of pregnancy. When a woman seeks abortion, the consulted physician and the woman certify on the abortion registration formula that information about abortion procedures and risks has been provided and received. In 1983, the Norwegian National Assembly (Stortinget) turned down a proposal of changing the abortion law to include mandatory counseling for abortionseeking women. At this time there were no Norwe15 -868824
gian studies on the decision-making process among pregnant women nor on the needs for counseling women with unplanned pregnancies. The aim of this study is to investigate the needs that abortion-seeking women have for medical information and to what extent medical professionals take part in the decision-making process. MATERIAL AND METHODS From 1 January 1983 to 15 July 1983, 472 women demanding abortion at the Department of Gynecology, University Hospital of Trondheim, Norway, Scand J Prim Health Care 1986; 4
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Finn Egil Skjeldestad
Table I. Sociodemographic data (N=403) ~~
Living alone
c High school
3
c High school z High school
Mean age (YRS)
137 30.2*
39 28.9*
135 22.3
Occupation At home Education Employed Unemployed Others
38.0% 3.6% 52.6 % 2.9 % 4.9%
17.9% 25.6% 48.8 % 7.7 % 0.7 %
7.4% 28.1 % 36.3 % 14.1 % 14.0%
14.6 % 85.4%
46.2 % 53.8%
66.7 % 33.3 %
n=
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~~
Marriedcohabitants
Parity 0 1+
*
High school
Total
92 23.9
403 26.0
57.6% 32.6% 3.3% 5.4%
69 106 170 29 29
78.3 % 21.7%
200 203
Significantly different to groups without asterisk.
were asked to take part in the study. The study population consists of 405 (86%) women, while 67 women were not invited to enter the study due to practical difficulties (vacation). These 67 women, however, did not differ from the study population in terms of age and parity. Six of the 405 women refused to answer some of the questions and two of these women were excluded from the analyses completely. The investigator did all the interviews following the clinical examination. The interviews were standardized. The study applied only to women who were admitted to the hospital to have induced abortion. The study population was divided into four groups of women according t o marital status and educational level. Group 1 and group 2 consisted of women living in cohabitation and with an educational level less than high school (group 1,