Abortion patients' perspectives on enhancing a telemedicine model of post-abortion contraception: a qualitative study.

IF 3.4 3区 医学 Q1 FAMILY STUDIES BMJ Sexual & Reproductive Health Pub Date : 2024-09-04 DOI:10.1136/bmjsrh-2024-202428
Nicola Boydell, Sophie Buijsen, John Joseph Reynolds-Wright, Sharon T Cameron, Jeni Harden
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Abstract

Background: Access to post-abortion contraception (PAC) is critical for reducing unintended pregnancies and supporting reproductive decision-making. Patients often face challenges in identifying, accessing and initiating their preferred contraceptive methods post-abortion. This may be particularly so with telemedicine models of care with absence of in-person appointments, and reduced opportunities to provide some contraceptive methods. This qualitative service evaluation explored patients' perspectives on PAC consultations and decision-making to inform future PAC service models in the era of telemedicine.

Methods: Qualitative interviews with 15 patients who had telemedicine medical abortion at home up to 12 weeks' gestation. Data were analysed using reflexive thematic analysis.

Results: Contraceptive discussions during pre-abortion consultations were valued for supporting informed choices about future contraceptive use. Decision-making was influenced by previous contraception experiences, emotional state at the time of abortion and concerns about contraceptive 'failure'. Some preferred non-hormonal methods due to past negative experiences with hormonal contraceptives. However, limited information about 'natural' contraceptive methods and concerns about discussing these with healthcare professionals were described. Barriers to accessing preferred methods, particularly long-acting reversible contraception (LARC), included reduced availability of appointments and caring responsibilities. Fast-tracked appointments for LARC fitting post-abortion were valued. The need for flexible PAC consultations and access after abortion, for example, remote consultations complemented by personalised interactions with sexual and reproductive health experts, was emphasised.

Conclusion: The findings highlight the need for flexible and more accessible PAC service models in the era of telemedicine care to ensure timely access to preferred contraceptive methods.

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流产患者对加强流产后避孕远程医疗模式的看法:一项定性研究。
背景:流产后避孕(PAC)对于减少意外怀孕和支持生殖决策至关重要。患者在人工流产后确定、获得和启动其首选的避孕方法时往往面临挑战。尤其是在远程医疗模式下,由于没有面对面的预约,提供某些避孕方法的机会就更少了。这项定性服务评估探讨了患者对 PAC 咨询和决策的看法,为远程医疗时代未来的 PAC 服务模式提供参考:方法:对 15 名妊娠 12 周以内在家进行远程医疗人工流产的患者进行定性访谈。采用反思性主题分析法对数据进行分析:结果:流产前咨询中的避孕讨论对于支持未来避孕药具使用的知情选择很有价值。以往的避孕经验、流产时的情绪状态以及对避孕 "失败 "的担忧都会影响决策。由于过去使用激素避孕药的负面经历,一些人倾向于选择非激素避孕方法。然而,关于 "自然 "避孕方法的信息有限,以及与医护人员讨论这些方法时的顾虑也被描述出来。获得首选避孕方法,特别是长效可逆避孕法(LARC)的障碍包括预约时间减少和护理责任。流产后快速预约长效可逆避孕药具安装受到重视。她们强调需要在流产后进行灵活的 PAC 咨询和获取,例如,远程咨询辅以与性健康和生殖健康专家的个性化互动:研究结果强调,在远程医疗时代,需要灵活且更方便的 PAC 服务模式,以确保及时获得首选的避孕方法。
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来源期刊
BMJ Sexual & Reproductive Health
BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine
CiteScore
5.10
自引率
6.10%
发文量
38
期刊介绍: BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.
期刊最新文献
Shifting discourses, changing interests? How the language of sexual and reproductive health has evolved in the past 50 years. "That's not how abortions happen": a qualitative study exploring how young adults navigate abortion misinformation in the post-Roe era. Attitudes towards the regulation and provision of abortion among healthcare professionals in Britain: cross-sectional survey data from the SACHA Study. Reported side effects from hormonal contraceptives among those seeking abortion care versus contraceptive services. The post-Roe potential of mifepristone and misoprostol in the United States.
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