Factors influencing women's levels of satisfaction with first-trimester surgical abortion

Abstract

Contraception 93 (2016) 164 – 169 Original research article Factors influencing women's satisfaction with surgical abortion ☆,☆☆,★ Candice Tilles 1 , Ashleigh Denny 2 , Catherine Cansino, Mitchell D. Creinin ⁎ Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA Received 19 June 2015; revised 21 September 2015; accepted 22 September 2015 Abstract Objective: Investigate which specific factors of abortion-related healthcare influence the overall satisfaction of women undergoing surgical abortion. Study Design: Between May and December 2014, we invited women undergoing first-trimester surgical abortion without sedation at six Northern California reproductive health clinics from two clinic systems (four clinics in System A and two clinics in System B) to complete an anonymous survey in the recovery room. The survey obtained demographic information and inquired about the women's level of satisfaction with different aspects of care (very satisfied, somewhat satisfied, not satisfied or dissatisfied, somewhat dissatisfied or very dissatisfied). The survey asked women to rank the three most important factors that contributed to their level of satisfaction. We analyzed the results using univariate and descriptive analyses to assess trends in responses related to level of satisfaction based on demographic and other variables. Results: A high percentage of women were very satisfied with their overall experience in both systems (A=79%, B=84%, p=0.34). Only 2% of women in System A and 1% in System B responded that they were neutral or not satisfied. The top three aspects of care ranked as most important were the same from both systems: ability to get an appointment in a timely manner, courtesy of staff and being informed as much as they wanted to know. Women were very satisfied or somewhat satisfied with these features of their care within both systems. Conclusion: Women are generally very satisfied by the first-trimester surgical abortion care they receive in different clinics. Although each clinic and system provides unique care, the factors contributing to women's level of satisfaction are consistent. Implications Statement: The most important factors that contribute to women's satisfaction with their first-trimester surgical abortion experience include the ability to get an appointment quickly, courtesy of the staff and being provided with information and responses to their questions. © 2016 Elsevier Inc. All rights reserved. Keywords: Abortion; Satisfaction; Courtesy; Timeliness 1. Introduction The Guttmacher Institute reported that 1.06 million abortions were performed in the United States in 2011 [1]. Although most abortions are performed early in pregnancy Presented in part as a poster abstract at the North American Forum on Family Planning, Chicago, IL, USA, November 14–16, 2015. Funding: none. Conflicts of Interest: none. ⁎ Corresponding author at: University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA 95817. Tel.: +1-916-734-6670. E-mail address: mdcreinin@ucdavis.edu (M.D. Creinin). Dr. Tilles is currently in the Department of Obstetrics and Gynecology at Harbor-UCLA Medical Center, Torrance, CA, USA. Dr. Denny is currently in the Department of Obstetrics and Gynecology at Jefferson University, Philadelphia, PA, USA. http://dx.doi.org/10.1016/j.contraception.2015.09.012 0010-7824/© 2016 Elsevier Inc. All rights reserved. and women often have a choice between medical and surgical abortions, approximately 81% of all abortions are performed surgically [2]. Just as with any other medical procedure, high patient satisfaction should be a primary goal in abortion care. Whereas multiple studies investigate acceptability of medical abortion, much less has been published in the last 15 years about factors influencing women's satisfaction with surgical abortion. Medical abortion studies show very high acceptability; the data can be assessed in aggregate to simply mean that women who are able to access abortion services are generally happy because they were able to get an abortion [3–7]. Although few studies specifically explore acceptability of surgical abortion, [8,9] we might expect overall results similar to medical abortion. Although recent research has evaluated clinic-level factors that contribute to a positive