Social support in the post-abortion recovery room: evidence from patients, support persons and nurses in a Vancouver clinic

Veiga, Mariana B.; Lam, Melanie Y.; Gemeinhardt, Carla; Houlihan, Edwina; Fitzsimmons, Brian; Hodgson, Zoë G.

doi:10.1016/j.contraception.2010.07.019

Cited by 16 publications

(28 citation statements)

References 16 publications

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“…This is in contrast to most post-abortion studies in which data collection occurs in health facilities [3, 26–29] and carries a high risk of bias introduced by the health facility environment. Another strength of this study is the concurrent qualitative and quantitative methods, which ensured both breadth and depth and which is rarely the case in abortion research, to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 93%

Role-players in abortion decision-making in the Accra Metropolis, Ghana

2014

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BackgroundMaking the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana.MethodsA retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data.ResultsThe findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and “Others” (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations.ConclusionA number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision.

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Section: Discussionmentioning

confidence: 93%

Role-players in abortion decision-making in the Accra Metropolis, Ghana

2014

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“…However, lack of social support may also independently be associated with poor health related quality of life. Studies in settings where abortion is legal have shown that social support may lead to improved psychological outcomes following an induced abortion [8,9]. We therefore extended a similar argument to the treatment of abortion complications, assuming that social support would be protective in the association between abortion complications and HRQoL.…”

Section: Discussionmentioning

confidence: 92%

“…Lack of social support is commonly cited as a reason for seeking an induced abortion [7], and could conceivably affect HRQoL, even in the absence of abortion or abortion complications. Yet when available, social support is associated with improved psychological outcomes following an abortion, and following treatment for abortion complications [8,9]. Differences in HRQoL may vary depending on availability of and satisfaction with social support.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and social support among women treated for abortion complications in western Uganda

Levine

Jenny

Ngonzi

et al. 2013

Health and Quality of Life Outcomes

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BackgroundWhile the impact of abortion complications on clinical outcomes and healthcare costs has been reported, we found no reports of their impact on Health-Related Quality of Life (HRQoL), nor the role of social support in moderating such outcomes. In this study, we performed an assessment of the relationship between abortion complications, HRQoL and social support among women in Uganda.MethodsWe interviewed women who were discharged after treatment for abortion complications and, as a comparison, women visiting a regional referral hospital for routine obstetric care. We administered the EuroQol instrument and the Social Support Questionnaire Short-Form, and collected demographic and socioeconomic data. We performed descriptive analyses using t-tests, Wilcoxon rank-sum tests and chi-square tests, and multivariable linear regressions with interaction effects to examine the associations between abortion complications, EQ-5D utility scores and social support.ResultsOur study included 139 women (70 with abortion complications, and 69 receiving routine obstetric care). In four out of the 5 dimensions of the EQ-5D, a larger proportion of women with abortion complications reported “some or severe” problems than women receiving routine obstetric care (self-care: 42% v 24%, p=0.033; usual activities: 49% v 16%, p<0.001; pain/discomfort: 68% v 25%, p<0.001; and anxiety/depression: 60% v 22%, p<0.001). After adjusting for age, social support, wealth tertile, employment status, marital status, and HIV status, women with abortion complications had a 0.12 (95% CI: 0.07, 0.18, p < 0.001) lower mean EQ-5D utility score than those receiving routine obstetric care. An analysis of the modifying effect of social support showed that a one-unit higher average number of people providing social support was associated with larger mean difference in EQ-5D utility score when comparing the two groups, while a one unit higher average satisfaction score with social support was associated with smaller mean differences in EQ-5D utility score.ConclusionsOur study suggests that abortion complications are associated with diminished HRQoL and the magnitude of the association depends on social support. However, the mediating role of social support in a setting of social and legal proscriptions to induced abortion is complex.

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“…A recent review of the literature evaluating the adequacy of pain management for first-trimester abortion concluded that many patients who do not receive general anaesthesia find surgical abortion extremely uncomfortable despite any medications that may have been administered 3. In one study that examined the role of a ‘support person’ in the post-anaesthesia recovery room after an abortion, the presence of social support was perceived as overwhelmingly positive to both the patient and support person 4. It is therefore likely that a doula could contribute to pain management in a manner that would augment the various analgesia medications with the exception, of course, of general anaesthesia.…”

Section: Doulas In Abortion Carementioning

confidence: 99%