title: How do women seeking abortion choose between surgical and medical abortion? Perspectives from abortion service providers.
abstract: BACKGROUND
  Depending on availability, many Australian women seeking an abortion will be faced with the choice between surgical or medical abortion. Little is known about the factors that influence Australian women's choice of method.
  
  
  OBJECTIVE
  Through the perspectives of abortion service providers, this study aimed to explore the factors that contribute to Australian women's decision to have a surgical or medical abortion.
  
  
  METHODS
  In 2015, in-depth interviews were conducted with fifteen Victorian-based key informants (KIs) directly providing or working within a service offering medical abortion. Ten KIs were working at a service that also provided surgical abortion. Interviews were semi-structured, conducted face-to-face or over the telephone, transcribed verbatim and analysed thematically.
  
  
  RESULTS
  KIs described varying levels of awareness of medical abortion, with poorer awareness in regional areas. When it comes to accessing information, women were informed by: their own research (often online); their own experiences and the experiences of others; and advice from health professionals. Women's reasons for choosing surgical or medical abortion range from the pragmatic (timing and location of the method, support at home) to the subjective (perceived risk, emotional impact, privacy, control, and physical ability).
  
  
  CONCLUSIONS
  Women benefit from an alternative to surgical abortion and are well-placed to choose between the two methods, however, challenges remain to ensure that all women are enabled to make an informed choice. KIs identify the need to: promote the availability of medical abortion; address misconceptions about this method; and increase general practitioner involvement in the provision of medical abortion.
authors.affiliation: Gender and Women's Health, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Newton
authors.affiliation: The Royal Women's Hospital, Parkville, Victoria, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Bayly
authors.affiliation: Family Planning Victoria & Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
authors.forename: Kathleen
authors.initials: K
authors.lastname: McNamee
authors.affiliation: Pregnancy Advisory Service, The Royal Women's Hospital, Parkville, Victoria, Australia.
authors.forename: Annarella
authors.initials: A
authors.lastname: Hardiman
authors.affiliation: Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Bismark
authors.affiliation: Women's Health Victoria, Melbourne, Victoria, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Webster
authors.affiliation: Gender and Women's Health, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. l.keogh@unimelb.edu.au.
authors.forename: Louise
authors.initials: L
authors.lastname: Keogh
mesh_terms: D000023:Abortion Applicants / Q000523:psychology*; D000028:Abortion, Induced / Q000379:methods / Q000523:psychology*; D002755:Choice Behavior; D004644:Emotions; D005260:Female; D006176:Gynecology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009774:Obstetrics; D057240:Patient Preference; D018907:Privacy; D036301:Qualitative Research; D034121:Reproductive Health Services; D012307:Risk Factors; D012944:Social Support; D013997:Time Factors
keywords: Australia; abortion; health professionals; medical abortion; patient choice