A good abortion experience: A qualitative exploration of women's needs and preferences in clinical care

•Women generally value similar aspects of care during birth and abortion.•Needs may differ in birth and abortion care due to circumstances and social context.•Some women value being affirmed as moral decision makers by abortion providers.•Emotional needs guide women's preferences for degree of presence during abortion.•Women fearful of judgment from others for having an abortion value discreet care.

What do women ending their pregnancies want and need to have a good clinical abortion experience? Since birth experiences are better studied, birth stories are more readily shared and many women who have had an abortion have also given birth, we sought to compare women's needs and preferences in abortion to those in birth. We conducted semi-structured intensive interviews with women who had both experiences in the United States and analyzed their intrapartum and abortion care narratives using grounded theory, identifying needs and preferences in abortion that were distinct from birth. Based on interviews with twenty women, three themes emerged: to be affirmed as moral decision-makers, to be able to determine their degree of awareness during the abortion, and to have care provided in a discreet manner to avoid being judged by others for having an abortion. These findings suggest that some women have distinctive emotional needs and preferences during abortion care, likely due to different circumstances and sociopolitical context of abortion. Tailoring services and responding to individual needs may contribute to a good abortion experience.