' a one stop shop in their own community': Medical abortion and the role of general practice.

BACKGROUND: The introduction to Australia of modern medical abortion methods, which require less specialist expertise and equipment than the more traditional surgical methods, have brought an as yet unrealised potential to improve access to abortion services. AIMS: To investigate the potential for expanding the role of general practice in the provision of medical abortion in Victoria. MATERIALS AND METHODS: In 2015, in-depth interviews were conducted with 19 experts in abortion service provision in Victoria. A semi-structured interview schedule was used to guide the interviews. Interviews were transcribed verbatim and transcripts analysed thematically. RESULTS: Participants were largely very supportive of the provision of early medical abortion in general practice as a way of increasing abortion access for women, particularly in rural and regional communities. Access to abortion was seen as an essential component of women's comprehensive health care and therefore general practitioners (GPs) were perceived as ideally placed to provide this service. However, this would require development and implementation of new service models, careful consideration of GP and nurse roles, strengthening of partnerships with other health professionals and services in the community, and enhanced training, support and mentoring for clinicians. CONCLUSION: The application of these findings by relevant health services and agencies has the potential to increase provision of medical abortion services in general practice settings, better meeting the health-care needs of women seeking this service.

How do women seeking abortion choose between surgical and medical abortion? Perspectives from abortion service providers.

BACKGROUND: Depending on availability, many Australian women seeking an abortion will be faced with the choice between surgical or medical abortion. Little is known about the factors that influence Australian women's choice of method. AIM: Through the perspectives of abortion service providers, this study aimed to explore the factors that contribute to Australian women's decision to have a surgical or medical abortion. MATERIALS AND METHODS: In 2015, in-depth interviews were conducted with fifteen Victorian-based key informants (KIs) directly providing or working within a service offering medical abortion. Ten KIs were working at a service that also provided surgical abortion. Interviews were semi-structured, conducted face-to-face or over the telephone, transcribed verbatim and analysed thematically. RESULTS: KIs described varying levels of awareness of medical abortion, with poorer awareness in regional areas. When it comes to accessing information, women were informed by: their own research (often online); their own experiences and the experiences of others; and advice from health professionals. Women's reasons for choosing surgical or medical abortion range from the pragmatic (timing and location of the method, support at home) to the subjective (perceived risk, emotional impact, privacy, control, and physical ability). CONCLUSIONS: Women benefit from an alternative to surgical abortion and are well-placed to choose between the two methods, however, challenges remain to ensure that all women are enabled to make an informed choice. KIs identify the need to: promote the availability of medical abortion; address misconceptions about this method; and increase general practitioner involvement in the provision of medical abortion.

Reasons women give for abortion: a review of the literature.

The aim was to identify from empirical research that used quantitative or qualitative methods the reasons women give for having an abortion. A search was conducted of peer-reviewed, English language publications indexed in eight computerized databases with publication date 1996-2008, using keywords 'abortion' and 'reason' (Medline: 'induced abortion' OR 'termination of pregnancy' OR 'elective abortion' and 'reason'). Inclusion criteria were empirical research on humans that identified women's reasons for undergoing an abortion, conducted in 'high-income' countries. 19 eligible papers were found. Despite variation in methods of generating, collecting, and analysing reasons, and the inadequacy of methodological detail in some papers, all contributed to a consistent picture of the reasons women give for having an abortion, with three main categories ('Woman-focused', 'Other-focused', and 'Material') identified. Ambivalence was often evident in women's awareness of reasons for continuing the pregnancy, but abortion was chosen because continuing with the pregnancy was assessed as having adverse effects on the life of the woman and significant others. Women's reasons were complex and contingent, taking into account their own needs, a sense of responsibility to existing children and the potential child, and the contribution of significant others, including the genetic father.

Reasons women give for contemplating or undergoing abortion: a qualitative investigation in Victoria, Australia.

OBJECTIVE: To increase understanding of women's perspectives on considering or undergoing elective abortion. DESIGN: Qualitative study. SETTING: A large public women's hospital in the state of Victoria, Australia. SAMPLE: Sixty women who had contacted a public pregnancy advisory service in Victoria, Australia, seeking information, advice, or appointments in relation to an unplanned or unwanted pregnancy. METHODS: Qualitative telephone interviews. The iterative qualitative analysis employed the five stages of a thematic framework approach. MAIN OUTCOME MEASURES: Themes in women's accounts of considering or undergoing elective abortion. RESULTS: Women's accounts emphasized their reasons for considering or seeking abortion. Decisions were made in the context of their lives as a whole; influences were usually contingent and multiple. Reasons related to the woman herself, the potential child, existing children, her partner and other significant relationships, and financial matters. CONCLUSIONS: This research used qualitative methods to produce the only recent study of its kind in Australia. Women's accounts reveal the complex personal and social contexts within which reproductive events must be comprehended and the thoughtfulness with which they make decisions. Results of this research will assist health-care professionals to increase their insights into women's reproductive experiences.