Assistant Professor of Public Health, Augustana College, Rock Island, IL, USA.
Doctoral Student, CUNY Graduate Center, New York, NY, USA.
Sex Reprod Health Matters. 2020 Dec;28(1):1730122. doi: 10.1080/26410397.2020.1730122.
Abortion providers' approaches to patient-centred pregnancy tissue viewing (PCV) - when a patient requests to see their products of conception - is understudied in abortion care. This mixed-method study aimed to identify: (1) if, when, and how PCV is facilitated at US independent abortion clinics; (2) how staff are trained to offer viewing; and (3) provider experiences facilitating PCV. We surveyed administrators from 22 independent abortion clinics affiliated with the Abortion Care Network about their PCV practices and then completed in-depth semi-structured interviews with 25 providers to better understand their experiences facilitating PCV. Results indicate that most of the clinics that provide PCV do so by patient request. A variety of providers facilitate viewing, including counsellors, educators, physicians, nurses, and medical assistants. Timing, viewing location, and staff training vary by facility. Benefits of and barriers to PCV emerged through three themes: (1) patient-centred care; (2) misinformation about fetal tissue; and (3) personal navigations as providers. Providers and administrators report PCV aligns with their patient-centred clinic missions and offers patients opportunities for choice, closure, and access to information. Yet, anti-abortion misinformation about fetal tissue impacts the ways providers must navigate complex conversations about PCV professionally and personally. Clinic resources and concern about adverse patient reactions to identifiable fetal parts present barriers to offering viewing. Understanding providers' experiences and approaches to PCV is an important first step to developing quality practices that can be shared across clinics. The findings of this study support the need for more research and training on PCV in abortion care.
堕胎服务提供者在妊娠组织查看（PCV）方面的方法——当患者要求查看自己的胚胎组织时——在堕胎护理中研究不足。这项混合方法研究旨在确定：（1）美国独立堕胎诊所是否、何时以及如何促进 PCV；（2）工作人员如何接受提供查看的培训；以及（3）提供者促进 PCV 的经验。我们调查了与堕胎护理网络有关联的 22 家独立堕胎诊所的管理人员，了解他们的 PCV 实践情况，然后对 25 名提供者进行了深入的半结构化访谈，以更好地了解他们促进 PCV 的经验。结果表明，大多数提供 PCV 的诊所都是应患者要求提供的。各种提供者都可以进行查看，包括咨询师、教育工作者、医生、护士和医疗助理。查看的时间、地点和工作人员培训因机构而异。通过三个主题出现了 PCV 的好处和障碍：（1）以患者为中心的护理；（2）关于胎儿组织的错误信息；以及（3）提供者的个人导航。提供者和管理人员报告称，PCV 符合他们以患者为中心的诊所使命，并为患者提供了选择、结束和获取信息的机会。然而，关于胎儿组织的反堕胎错误信息影响了提供者在专业和个人层面上必须如何处理关于 PCV 的复杂对话的方式。诊所资源和对患者对可识别胎儿部位反应的担忧是提供查看的障碍。了解提供者在 PCV 方面的经验和方法是制定可以在诊所之间共享的高质量实践的重要第一步。这项研究的结果支持在堕胎护理中对 PCV 进行更多研究和培训的需求。
