Normalising abortion: what role can health professionals play?

Abstract

BackgroundDespite being a common gynaecological procedure, abortion continues to be widely stigmatised. The research and medical communities are increasingly considering ways of reducing stigma, and health professionals have a role to play in normalising abortion as part of routine sexual and reproductive healthcare (SRH). We sought to investigate how health professionals may normalise abortion and challenge prevailing negative sociocultural narratives.MethodsAs part of the Sexuality and Abortion Stigma Study (SASS), qualitative secondary analysis was conducted on two datasets containing health professionals’ accounts of providing abortion in Scotland and England. A subsample of 20 interviews were subjected to in-depth, thematic analysis.ResultsFour key themes were identified in heath professionals’ accounts: (1) encountering resistance to abortion from others working in SRH; (2) contending with prevailing negative sociocultural narratives of abortion; (3) enacting overt positivity towards abortion provision; and (4) presenting abortion as part of normal, routine healthcare.ConclusionsIt is clear that negative attitudes toward abortion persist both inside and outside of healthcare systems, and need to be challenged in order to destigmatise those accessing and providing services. Health professionals can play a key role in normalising abortion, through the ways in which they frame their work and present abortion to women they treat, and others more widely. Our analysis suggests a key way to achieve this is by presenting abortion as part of normal, routine SRH, but that appropriate support and structural change are essential for normalisation to become embedded.

What should medical students be taught about abortion? An evaluation of student attitudes towards their abortion teaching and their future involvement in abortion care

“…Recent research on abortion-related stigma states that 'work remains to be done to dismantle abortion negativity embedded in the healthcare system' [2]. The UCLMS teaching aims to counteract this negativity and abortionrelated stigma in a number of ways.…”

“…University College London Medical School, London, UK. 2 Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 3 Institute of Health Informatics, University College London, London, UK.…”

“…One in three UK women will have an abortion by the age of 45 [1], making abortion provision an essential and common aspect of reproductive healthcare. Despite this, abortion remains an ethically contested and stigmatised issue both for those who have them and for those who provide them [2]. This is likely to be a significant factor in the decreasing number of junior doctors interested in providing abortions in the UK; only 33 Obstetrics and Gynaecology (O&G) trainees have completed the Royal College of Obstetricians and Gynaecologists (RCOG) specialist abortion care training since 2007 and only 20 clinicians have undertaken the Faculty of Sexual and Reproductive Health's (FSRH) abortion care module in that time.…”

Contraceptive priorities among women seeking family planning services in Finland in 2017–2019

“…The relatively low proportion of women prioritizing effectiveness of their contraceptive method in Finland and Sweden might correlate to the easily accessible and affordable contraception services in these countries. In a setting of relatively low barriers to abortion care, an unintended pregnancy may not necessarily be considered a contraceptive failure; seeking abortion care may be only one reproductive option among others [26,27].…”

What should medical students be taught about abortion? An evaluation of student attitudes towards their abortion teaching and their future involvement in abortion care

“…One in three UK women will have an abortion by the age of 45 (1), making abortion provision an essential and common aspect of reproductive healthcare. Despite this, abortion remains an ethically contested and stigmatised issue both for those who have them and for those who provide them (2). This is likely to be a signi cant factor in the decreasing number of junior doctors interested in providing abortions in the UK; only 33 Obstetrics and Gynaecology (O&G) trainees have completed the Royal College of Obstetricians and Gynaecologists (RCOG) specialist abortion care training since 2007 and only 20 clinicians have undertaken the Faculty of Sexual and Reproductive Health's (FSRH) abortion care module in that time.…”