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Decision-making concerning unwanted pregnancy in general practice.

Maaike S Goenee1, Gé A Donker2, Charles Picavet1

  • 1Research Centre for Sexuality, Rutgers WPF, Utrecht and.

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Summary

General practitioners (GPs) in the Netherlands counsel women on unwanted pregnancies. Discussing all options may aid decision-making, with 8% of women altering their abortion decisions after GP consultations.

Keywords:
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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.