Psychology of Abortion: A Qualitative Exploration of Women's Quality of Life after Termination of Pregnancy Service Provision.

Background: Although safe abortion is a human right, some research indicates that abortion can be considered a life event that could trigger an adverse psychological reaction, including mental ill health, particularly in vulnerable women. Unplanned pregnancies and abortions affect women's mental and physical health while increasing psychological risk; hence, measures are needed to improve the quality of life (QoL) of women post termination of pregnancy (ToP). The purpose of this study was to explore the psychological effects of abortion on women provided with this service in Rwanda, and factors surrounding QoL after service provision. Methods: An interpretive description design was used. Focus group discussions were used to hear the voices of 30 women and girls who had sought ToP services. The six steps of interpretive description together with framework analysis guided the analysis. Results: From responses provided by the participants with experience of ToP services five themes and six sub-themes were generated, (1) Ambivalence with mixed feelings and uncertainty, anger, wonder, and frustration; (2) Insecurity and abortion stigma, with judgement and inadequacy; (3) Personalized care with respectful care and dignity and self-reliance; (4) Lack of connection with relationships, coping, and a sense of belonging; (5) Wellness and preferences for care with hope and positive physical health. Conclusion: The lack of psychological support post ToP negatively affects QoL and indicates an opportunity to include a psychological support package in the ToP service provision, which is the predictor of positive mental health to improve QoL in Rwanda.