Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, Division of San Francisco General Hospital, San Francisco, CA 94110, USA.
Int J Gynaecol Obstet. 2012 Mar;116(3):244-8. doi: 10.1016/j.ijgo.2011.10.016. Epub 2011 Dec 12.
To describe how women terminating a pregnancy for fetal or maternal complications decide between surgical (dilation and evacuation [D&E]) and medical abortion.
A qualitative study was conducted among women who underwent D&E or medical abortion before 24 weeks of gestation for fetal anomalies or pregnancy complications at an academic medical center where both methods are offered. Women were interviewed by phone 1 week after the procedure about their counseling experiences and reasons for choosing a particular method. Data were analyzed by 3 researchers using a grounded theory approach, and interviews were stopped upon thematic saturation.
Of the 21 women, 13 (62%) chose D&E and 8 (38%) chose medical abortion. Key themes that emerged from the interviews were valuing the ability to choose the method, and the importance of religious beliefs, abortion attitudes, and emotional coping style. Women's preferences for a method were largely based on their individual emotional coping styles.
Decisions to undergo D&E or medical abortion are highly personal and could affect how women recover after ending a desired pregnancy. Women should be offered counseling about and access to both methods. Understanding these decision processes may help when counseling women faced with these diagnoses and decisions.
描述因胎儿或母体并发症而终止妊娠的女性如何在手术（扩张和排空[D&E]）和药物流产之间做出选择。
在一家学术医疗中心对因胎儿畸形或妊娠并发症在 24 周前接受 D&E 或药物流产的女性进行了一项定性研究，该中心同时提供这两种方法。在手术后一周，通过电话对女性进行采访，了解她们的咨询经验以及选择特定方法的原因。通过 3 位研究人员使用扎根理论方法进行数据分析，并在主题饱和时停止访谈。
21 名女性中，13 名（62%）选择 D&E，8 名（38%）选择药物流产。访谈中出现的主要主题是重视选择方法的能力，以及宗教信仰、堕胎态度和情绪应对方式的重要性。女性对方法的偏好主要基于她们个体的情绪应对方式。
选择 D&E 或药物流产是非常个人化的决定，可能会影响女性在结束期望的妊娠后如何恢复。应向女性提供关于这两种方法的咨询并确保其可获得这两种方法。了解这些决策过程可能有助于在为面临这些诊断和决策的女性提供咨询时提供帮助。
