Women's Experiences With Doula Support During First-Trimester Surgical Abortion

Abstract

INTRODUCTION: Doula support, traditionally used during labor and delivery, has expanded into additional reproductive experiences, including miscarriage, adoption, and abortion. The objective of this study is to explore how doula support influences women's surgical abortion experiences. METHODS: We conducted semistructured interviews with women given the option to receive doula support during first-trimester surgical abortion. Dimensions explored included: 1) reasons women did or did not choose doula support; 2) key aspects of the doula interaction; and 3) future directions for doula support in abortion care. Interviews were transcribed and computer-assisted content analysis was performed; salient themes are presented. RESULTS: Thirty women were interviewed: 19 opted for and 11 opted against doula support. Opting for doula support related to procedure concerns, prior abortion experiences, and positive associations with doulas from media or personal experiences. Doula support benefits included: distraction, physical support, coping with pain, and doulas as nurturers. Declining doula support stemmed from feeling that additional support was not needed, not wanting additional people present during the procedure, and feeling that doulas did not belong in abortion care. Most of these (n=7) women subsequently regretted not having a doula. Universally women favored greater doula interaction, primarily to address psychosocial concerns. Several women indicated that doulas would take more time for discussion and have a richer understanding of women's needs compared with physicians or other medical professionals. CONCLUSION AND IMPLICATION: Women receiving first-trimester surgical abortion value social support in the form of doulas. This intervention has the potential to be further developed to help women address postabortion psychosocial needs.