"It's Not a One Size Fits All": Service Users' Views on How Service Structure Shapes Quality of Abortion Care in...

Abortion care in Britain has undergone significant transformation in recent years, with increasing use of medication, home management, and telemedicine. However, provision remains predominantly through specialist standalone clinics, particularly in England. Drawing on the interlinking frameworks of abortion exceptionalism, stigma, and quality of care, we analyzed 48 qualitative interviews with people who recently had abortions to explore how service-users perceive different models of care in terms of access, continuity, holistic care, and the normalization of abortion. Participants highlighted the importance of both place (standalone vs. integrated) and provider (specialist vs. generalist). Primary care was seen as convenient and supportive of continuity (e.g., for post-abortion contraception) and normalization of abortion as routine healthcare. Specialist clinics, however, were valued for expertise and nonjudgmental care. Community sexual and reproductive health services offered a blend of these benefits. Preferences varied depending on individual circumstances, pointing to the need for flexible, person-centered care. This study contributes to ongoing discussions about how best to organize abortion services to support reproductive autonomy and equity. Importantly, structural change alone is insufficient; attention to the ongoing experience of stigma remains essential to delivering high-quality, person-centered abortion care.