Women Know Best—Findings from a Thematic Analysis of 5,214 Surveys of Abortion Care Experience



      Patient experience is an essential component of quality care. Few studies have comprehensively evaluated patient experiences of abortion care. The objectives of this study were to describe women's experiences of abortion care in their own words, and to determine themes across patient experiences.

      Study Design

      Data for this thematic analysis, a qualitative method that allows for the identification, analysis, and report of patterns or themes within data, come from a larger study of safety and quality of aspiration abortion care across 22 clinical sites. Participants completed an abortion experience survey including fixed choice questions and an open-ended question: “Is there anything you would like to tell us about your experience?” The data were then categorized by responses to another survey question: “Overall, was your experience about, better, or worse than you expected?”


      A total of 5,214 responses were analyzed. Women reported positive abortion care experiences with the majority of women rating their experience as better than expected (n = 3,600). Two major themes that emerged from the data include clinic- and patient-level factors that impact how patients rate their experiences. Analysis of the responses categorized in the worse than expected group (n = 136) found that women primarily faulted clinic-level factors for their negative experiences, such as pain control and management, and wait time for appointments and in clinic.


      This analysis highlights specific areas of abortion care that influence patients' experience. The few women who were disappointed by care in the clinic tended to fault readily modifiable clinical factors, and provided suggested areas of improvement to enhance positive experiences related to their abortion care.
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      Monica R. McLemore, PhD, MPH, RN, is an Assistant Professor in the Family Health Care Nursing Department and a Research Scientist at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.


      Sheila Desai, MPH, was the Research and Evaluation Manager for the Health Workforce Pilot Project at Advancing New Standards in Reproductive Health, University of California, San Francisco.


      Lori Freedman, PhD, is an Assistant Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences and a Medical Sociologist at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.


      Evelyn Angel James, CNM, WHNP-BC, is a doctoral candidate in the Community Health Systems Nursing Department and a Research Resident at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.


      Diana Taylor, PhD, RNP, MS, FAAN, is Professor Emerita in the Family Health Care Nursing Department and Director of Research and Evaluation of the Primary Care Initiative at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.