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Women's Experience of Decision-Making With Medication Abortion

Cappiello, Joyce PhD, FNP, FAANP; Merrell, Joy PhD, RN; Rentschler, Dorothy PhD, RN

MCN: The American Journal of Maternal/Child Nursing: September/October 2014 - Volume 39 - Issue 5 - p 325–330
doi: 10.1097/NMC.0000000000000063

Background: Medication abortion received regulatory approval in 2001 in the United States with healthcare providers increasingly offering this method. However, most studies in the United States have only explored acceptability and decision-making with women who participated in clinical trials. Overall, the literature on women's experience with a method that it is now widely available is under research in the United States.

Objective: To describe and analyze the women's experience as they choose the option of and experienced the process of medication abortion.

Design: A constructivist grounded theory study.

Setting: Outpatient clinical offices in a three-state area in the northeast region of the United States.

Participants: A purposive sample of 22 women aged 16 to 45 who experienced a medication abortion.

Methods: Data were collected by in-depth, open-ended, face-to-face interviews. The constant comparative method was used for analysis.

Results: Five interwoven categories emerged regarding women's initial decision to have a medication abortion: choosing a natural process, avoiding “surgery,” respecting the “baby,” scheduling to meet needs, and appreciating the home setting. The enhanced sense of personal control associated with the medication abortion option was the overriding reason given for choosing this method.

Conclusion: This study contributes to the paucity of literature on the reasons why women choose medication abortion. It is important for nurses to understand the complexity of medication abortion decision-making so that they can effectively support women through this process.

Medication abortion (an abortion caused by a pharmaceutical agent rather than a medical procedure) is becoming more common in the United States. This study provides insight as to why women might choose this approach.

Joyce Cappiello is an Assistant Professor of Nursing, University of New Hampshire, 4 Library Way, Durham, NH; and the Director of the ROE Consortium at Provide, PO Box 410164, Cambridge, MA. The author can be reached via e-mail at

Joy Merrell is a Professor of Public Health Nursing, College of Human and Health Sciences, Swansea University.

Dorothy Rentschler is a Retired Professor of Nursing, East Carolina University.

There are no conflicts of interest, financial interest or affiliation with any organization or company related to the material in this manuscript to report.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.