Decision-making concerning unwanted pregnancy in general practice

Area of Science:

• Family Medicine
• Reproductive Health
• Medical Ethics

Background:

• Abortion is legal in the Netherlands under specific conditions, requiring a mandatory 5-day reflection period initiated by a GP.
• General Practitioners (GPs) play a key role in managing the initial stages of pregnancy termination requests.

Purpose of the Study:

• To analyze the counseling provided by GPs for unwanted pregnancies.
• To investigate the link between counseling elements and women's decisions regarding pregnancy termination.

Main Methods:

• Utilized data from the NIVEL Primary Care Database Sentinel Practices (2004-2010).
• Employed standardized registration forms for unwanted pregnancy consultations.
• Applied chi-square and logistic regression analyses for data interpretation.

Main Results:

• Most women proceeded with abortion without changing their minds; about 16% were undecided.
• 8% of women who had decided on abortion altered their decision after GP consultation.
• Higher gestational age and discussion of alternatives increased the likelihood of changing minds; referral to abortion clinics decreased this likelihood.

Conclusions:

• Protocolized discussion of all options by GPs can support patient decision-making in cases of unwanted pregnancy.
• Enhanced training for GPs may improve their effectiveness in abortion counseling.