Choices about abortion method: assessing the quality of patient information leaflets in England and Wales


* Dr H. Bekker, Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds, LS2 9LT, UK.


Objective To assess the quality of patient leaflets regarding the choice between medical and surgical abortions.

Design Cross sectional survey.

Setting NHS and private providers of abortion services in England and Wales.

Sample Leaflets from three private providers, all teaching hospitals (n= 14) and a representative sample of NHS district hospitals (n= 27), accessed by approximately 100,000 women per year.

Methods On telephoning the above abortion services, the leaflets provided to women choosing to have medical or surgical abortions were requested. Content analysis of leaflets included: application of a coding frame assessing adequacy of information about options, risks and procedures; the Flesch Readability Ease scale.

Main outcome measures Provision of leaflet, adequacy of information and ease of readability.

Results Seventy-three percent (44/60) of contacted providers offered women a leaflet. Of these 44 leaflets, one mentioned medical and 15 surgical abortion methods only. Adequacy of information provision was low, with on average 10/23 points covered about the surgical method, 12/21 points about the medical method and 7/11 points about aftercare. Readability scores were poor with 24/44 (55%) rated as ‘difficult’ or ‘fairly difficult’. Among NHS providers, scores were slightly higher in the teaching than in the district hospitals.

Conclusions On average, leaflets provided half the information possible about the risks and procedures of medical and surgical methods. In addition, readability was rated as difficult in over half the leaflets. It seems unlikely that these leaflets enable women to make informed choices between abortion methods and, therefore, do not meet the requirements of current guidelines.