Induced Fetal Demise Prior to Later Medication Abortion: A Qualitative Study of Women's Experience With Digoxin Injection

TL;DR

This study explores women's physical and emotional experiences with digoxin injections used to induce fetal demise before a later abortion in Ethiopia.

Contribution

The study qualitatively identifies patient experiences and understanding of digoxin use in Ethiopia for induced fetal demise.

Findings

Participants experienced emotional discomfort carrying a demised fetus until abortion completion.

Forty percent of participants viewed induced fetal demise as a way to shorten the abortion process.

Abstract

Recent evidence suggests that providers who continue to use digoxin for induced fetal demise prior to later medication abortion should consider patient preferences in how they offer digoxin and consider tools to ensure patient understanding. This study aimed to qualitatively determine patients’ experiences with induced fetal demise using digoxin injection prior to later medication abortion.

This was a qualitative study of women who had induced fetal demise with digoxin injection prior to later medication abortion in Ethiopia, in 2023. The participants were interviewed about physical and emotional experiences with digoxin and their understanding of its purpose in the immediate post‐abortion period, before they were discharged from the hospital. Data were analyzed using a thematic analysis on One Code software.

A total of 20 participants were included in this study. The two overarching themes identified from the qualitative interviews were as follows: (1) emotional discomfort and varied understanding of digoxin's purpose; (2) digoxin injection‐related physical discomfort. Participants had a shared feeling of discomfort carrying a demised fetus after digoxin administration till the abortion process was completed. A significant proportion of them (8/20, 40%) described induced fetal demise as a procedure to shorten the abortion process.

Findings of some patients’ physical and emotional discomforts of digoxin injection to induce fetal demise in our study are consistent with findings in previous qualitative studies.

We qualitatively determined patients’ experiences with induced fetal demise using digoxin injection prior to later medication abortion in Ethiopia. We identified two overarching themes: (1) emotional discomfort and varied understanding of digoxin's purpose; (2) digoxin injection‐related physical discomfort.

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