European Journal of Obstetrics & Gynecology and Reproductive Biology
Selection bias in a study on how women experienced induced abortion
Section snippets
Introduction.
All women who in 1989 underwent induced abortion at the Department of Obstetrics and Gynecology in Malmö, which is the sole referral clinic for an urban population of about 230 000, were invited approximately 1 year later to attend an interview about their experience of the care and treatment provided in conjunction with abortion.
One third of the women refused to participate despite repeated reminders. For many of the women, the reason for non-participation seemed to be a sense of guilt that
Material and methods
In 1989 1285 women underwent induced abortion at University Hospital, Malmö. The interview prior to the abortion included questions about age, civil status, relations with their partner, education, occupation, nationality, reproductive history, any type of contraception used and medical history as a part of the usual counselling process. It was possible to assess whether any of these demographic factors were associated with non-participation in the planned follow-up interview.
At this first
Statistical methods.
Relationships between demographic characteristics, reproductive history, nationality and participation in the follow-up interview were expressed as odds ratios with 95% confidence intervals. An odds ratio below 1.0 means that the evaluated factor was more common among women who did not participate in the follow-up interview.
Results.
All women who underwent induced abortion had been offered a routine check-up approximately 1 week after the abortion. This visit is free of charge in Malmö. The purpose is to detect any infections, discuss the woman's psychological reaction with a view to offering help from a social worker if required, and to follow-up the implementation of recommendations for avoiding further unwanted pregnancies.
Of the series as a whole (n=1285, 167 (13%) did not attend the routine checkup; and of the 431
Discussion:
Although women in Sweden are legally entitled to demand induced abortion until the 18th gestational week, nonetheless for many it is a procedure that causes serious emotional upset and ethical concern. Thus it is open to question whether it is appropriate to ask women who have undergone induced abortion to attend an interview about their experience of the event. One third of the present series refused to be interviewed 1 year later about their experience in this respect.
Treatment and care given
Acknowledgements
This study has been supported by grants from HSF: Rådet för hälso-och sjukvårdsforskning (Council for Medical Health Care Research in southern Sweden) and FOA: Universitetssjukhuset MAS fonder för forskning och utveckling (Malmö University Hospital funds för research and development).
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