Women's experiences with doula support during first-trimester surgical abortion: a qualitative study

Abstract

Objective To explore how doula support influences women’s experiences with first-trimester surgical abortion. Study Design We conducted semi-structured interviews with women given the option to receive doula support during first-trimester surgical abortion in a clinic that uses local anesthesia and does not routinely allow support people to be present during procedures. Dimensions explored included: (1) reasons women did or did not choose doula support; (2) key aspects of the doula interaction; (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 received and 11 did not receive doula support. Reasons to accept doula support included: (1) wanting companionship during the procedure; (2) being concerned about the procedure. Reasons to decline doula support included (1) a sense of stoicism and desiring privacy; or (2) not wanting to add emotion to this event. Women who received doula support universally reported positive experiences with the verbal and physical techniques used by doulas during the procedure and most women who declined doula support subsequently regretted not having a doula. Many women endorsed additional roles for doulas in abortion care, including addressing informational and emotional needs before and after the procedure. Conclusion Women receiving first-trimester surgical abortion in this setting value doula support at the time of the procedure. This intervention has the potential to be further developed to help women address pre- and post-abortion informational and emotional needs. Implications In a setting that does not allow family or friends to be present during the abortion procedure, women highly valued the presence of trained abortion doulas. This study speaks to the importance of providing support to women during abortion care. Developing a volunteer doula service is one approach to addressing this need, especially in clinics that otherwise do not permit support people in the procedure room or for women who do not have a support person and desire one.

Integrating Doulas Into First‐Trimester Abortion Care: Physician, Clinic Staff, and Doula Experiences

“…Prior studies have demonstrated that women obtaining first‐trimester aspiration abortion value doula support . This study illustrates that abortion providers and clinic staff also benefit from having a dedicated support person present during the provision of first‐trimester aspiration abortion under local anesthesia.…”

“…Nonetheless, participants perceived this form of support as one way to provide more patient‐centered care in this very busy clinical setting. While this article does not include patient perspectives, prior studies have confirmed that women value doula support at the time of aspiration abortion . Clinical teams in high‐volume clinics can struggle with efficiency, comforting patients emotionally, and addressing informational and emotional needs.…”

What role do Death Doulas play in end‐of‐life care? A systematic review

“…Birth doulas have been described as paraprofessionals usually working in a fee‐for‐service model (Low, Moffatt, & Brennan, ). The “Doula” role has been adapted into contemporary midwifery models of care including: abortion doulas (Chora, Lymana, Tuskenb, Patelc, & Gilliama, ) and doulas for individuals with specific care needs such as women with an intellectual disability (McGarry, Stenfert Kroese, & Cox, ). With birth doulas now well established, we are seeing innovative hospital and community models in both the UK (Darwin, Green, McLeish, Willmot, & Spiby, ) and the US (Kozhimannil, Vogelsang, Hardeman, & Prasad, ) including doulas addressing inequity for women giving birth in lower socioeconomic circumstances.…”

Whither a Welfare-Funded ’Sex Doula' Programme?

“…These models originated with birth doulas, but now count among their number: end-of-life (death) doulas,18 abortion doulas,19 and specific-care doulas 20. Despite this variety, doulas can be characterised as non-medical coaches, facilitators, and assistants who offer skilled social, emotional, and practical support 21.…”