Anneli Kero

Legal abortion: a painful necessity.

This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

Ambivalence : a logical response to legal abortion : a prospective study among women and men

The aim of the study was to elucidate ambivalence in relation to legal abortion by studying emotions, attitudes, motives for abortion and ethical reasoning in a-strategic sample of women and men who, 1 year after abortion, expressed both positive and painful feelings in relation to the abortion. The study shows that social perspectives legitimate the decision to have an abortion whilst ethical perspectives complicate the decision. Nearly all women and men described having the abortion as an expression of responsibility. Almost one-half also had parallel feelings of guilt, as they regarded the abortion as a violation of their ethical values. The majority of the sample expressed relief while simultaneously experiencing the termination of the pregnancy as a loss coupled with feelings of grief/emptiness, in spite of the ambivalence, only one woman regretted the abortion. For the vast majority, the impact of the abortion had led to increased maturity and deepened self-knowledge. Thus, ambivalence might be regarded not only as problematic but also as indicating openness to the complexity of the abortion issue. Since incompatible values clash in connection with abortion, experiences of ambivalence become both logical and understandable.

Reactions and reflections in men, 4 and 12 months post-abortion.

Background:

‘Admission into a helping plan’: a watershed between positive and negative experiences in breast cancer

Cancer patients are in an exposed situation that raises certain psychosocial needs in contact with health care. Previous studies have mainly investigated these needs by assessments on pre‐defined categories.

Home abortion implies radical changes for women

Objective To gain knowledge about womens experiences, views and reactions regarding having a home abortion (medical abortion with the use of misoprostol at home). Methods One hundred women were interviewed one week post-abortion; this yielded both quantitative and qualitative data. Results The overwhelming majority of the women experienced wellbeing and were satisfied with their choice of abortion method. They appreciated the privacy and the comfort of being at home which also allowed the presence of a partner. The intake of mifepristone at the clinic was described by many in existential terms as an emotionally charged act, experienced by some as more difficult than expulsion at home. However, relief was the predominant emotional feeling during the expulsion day. Most women did not find it especially dramatic to see and handle the products of conception although some felt uncomfortable at the sight. Conclusion Given that they choose this method themselves and are well informed, women are able to handle the abortion process by themselves outside a clinical setting. The option to choose home abortion implies a radical change in empowerment for women. Also allowing them the possibility to take mifepristone at home would increase their privacy and personal integrity even more.

The impact of breast cancer on living an everyday life 4.5 - 5 years post-diagnosis - a qualitative prospective study of 39 women

Abstract Background. The survival of women with breast cancer has improved. There are many studies available describing different aspects of how the illness and its treatment affect the women. Usually these studies are cross-sectional and focus on assessments of a sample of women at a single point in time during post-treatment. These studies are important but of limited value if we are interested in understanding more about breast cancer in a life context. The present study is a contribution. Methods. A consecutive sample of 39 women was followed up by means of repeated thematic interviews about how they lived their lives, from the end of radiation therapy to a point four years later, i.e. 4.5–5 years post diagnosis. Results. Four different groups of women emerged. Largely, the first group evaluated the cancer initiated transformation of their lives in a positive way. The breast cancer helped them depart from a career treadmill or to positive interpersonal experiences. In the second group the cancer and its treatment seemed to pass without marked traces. The cancer made a difference for the third group, but both in positive and negative ways. A different life perspective or improved relationships were weighted against troublesome side effects from treatment. Finally, in the fourth group a bodily decline due to side effects and other health problems was predominant and this obstructed their chances of living a good life. Discussion. The narratives showed that being diseased by breast cancer has different impacts depending on how the woman lives her life – it is very much a matter of transition in a life context. The results are furthermore discussed in relation to adaptation and coping theory.

Home abortion - experiences of male involvement.

Objective To gain knowledge about the male partners experience of being present during an induced home abortion. Methods Twenty-three couples, whose male partner had been present when the woman aborted at home, were interviewed one to two weeks post-abortion. Results Each of the men supported his partner in her decision to have a home abortion, as this gave him the possibility of being near and of caring for her needs on the expulsion day. All the men were present and all their partners confirmed that they had been supportive. Half the men had been anxious prior to the expulsion, but most considered that their experiences during the expulsion had been ‘easier than expected’ and their dominant feeling was one of relief. Conclusions Abortion is an important life event. When taking place at home, it increases the possibility for the couple to share the experience. Sharing an abortion may have a positive impact on those men who lack a sense of responsibility regarding reproductive issues, such as contraceptive use. This could facilitate societys efforts to involve men as a target group in this field. Designing an abortion policy that caters for the needs of both partners is a challenge.

Breast cancer experience through the body : A consecutive, six-year longitudinal study of 24 women

BACKGROUND: Breast cancer is a disruptive s bodies in body experiences in a life context are not sufficiently acknowledged in breast cancer research. Due to the increasing number of breast cancer s ...Abstract presented at the IPOS 15th World Congress of Psycho-Oncology, 4-8 November 2013, Rotterdam, Netherlands

Why shouldn't one report on women's positive feelings with regard to abortion?

SIR: Those who assist women having a termination of pregnancy are hopefully motivated by the reasons you marshalled in your excellent Editorial in the October issue of this Journal; besides, ‘someone has to do it’. Kero et al., in the same issue, gave some interesting new insights but disregarded that induced abortions have ethical aspects beyond making the procedure as little unpleasant as possible. The article describes medical abortion in terms of (I quote selectively): ‘empowerment’, ‘personal integrity’, ‘acceptability’, ‘satisfaction’, ‘relief’, ‘more natural’, ‘pleased with their decision’, ‘greater autonomy’, ‘feelings of wellbeing’, ‘lack of emotional distress’, and ‘felt good’, which may reflect and sustain the notion that abortion is not much of an ethical dilemma in Sweden, a country with one of the highest abortion rates in western and northern Europe. Contraception is mentioned only once in passing, while nearly 50% of the interviewees had a repeat abortion. Medical abortion has the disadvantage of missing an excellent opportunity to initiate immediately long-acting contraception by means of an intrauterine device, implant or tubal occlusion.The paper by Sydsjö et al. published also in the same issue of this Journal, suggests that not lack of access but the interaction between lack of use of reliable contraceptives and the feeling that abortion is not an ethical issue of any significance partly explains the much higher abortion rates in Sweden compared with Finland for example. Furthermore, the extremely favourable opinion about medical abortion may not be justified if one considers a paper from neighbouring Finland. The authors compared abortion (at 564 days) medically (n 1⁄4 22,368) and surgically (n 1⁄4 20,251), and reported a less positive experience. According to them: ‘Both methods of abortion are generally safe, but medical termination is associated with a higher (20.0% compared with 5.6%, p 5 0.001) incidence of adverse events’. One yardstick for the quality of a society with a low birth rate is how well it is able to reduce the number of (repeat) terminations, without restricting access to abortion services. Success in such an undertaking is likely to persuade other countries to liberalise access to abortion services. We should perhaps demonstrate in our publications that we share this ideal.