Experiences of working with induced abortion: focus group discussions with gynaecologists and midwives/nurses.

BACKGROUND: While there exists an extensive amount of research regarding the medical aspects of abortion, there is a great lack of studies investigating staff's views and experiences of working in abortion services. AIMS: To elucidate gynaecologists' and midwives'/nurses' experiences, perceptions and interactions working in abortion services, their experiences of medical abortions and abortions performed at the woman's home. An additional aim was to illustrate gynaecologists', midwives' and nurses' visions of their future professional roles within the abortion services. METHOD: Three focus group discussions within each profession were carried out in 1-hour sessions with a total of 25 gynaecologists and 15 midwives/nurses from three different hospitals. RESULTS: The content analysis reflected that gynaecologists and midwives/nurses had no doubts about participating in abortions despite the fact that they had experienced complex and difficult situations, such as repeat and late-term abortions. They experienced their work as paradoxical and frustrating but also as challenging and rewarding. However, they were rarely offered ongoing guidance and continuously professional development education. For gynaecologists, as well as midwives/nurses, their experiences and perceptions were strongly linked to the concurrent development of abortion methods. The interaction between the professions was found to be based on great trust in each other's skills. CONCLUSIONS: In order to promote women's health, gynaecologists' and midwives'/nurses' need for a forum for reflection and ongoing guidance should be acted on. With a higher number of abortions done medically and a higher proportion of home abortions, midwives/nurses will get increased, responsibilities in the abortion services in the future.

Midwives' experiences of encountering women seeking an abortion.

In order to gain knowledge about midwives' clinical and emotional experiences of working with termination of pregnancy (TOP) and their perception of women's motives for having an abortion questionnaires were mailed to a representative sample of Swedish midwives (n = 258), and 84% responded. Responses to 17 statements were studied and interpreted. It was found that every third midwife had not at all worked with TOP, and every fifth had not done so in the preceding two years. Among those who had experienced this work, few midwives had considered changing their job or had had misgivings or feelings of inadequacy caused by encountering women seeking an abortion. Both working currently with TOP and for a longer period of time were found to evoke positive experiences in every other midwife. Midwives' perception of motives for abortion corresponded very well to motives provided by women themselves. Half the midwives had had misgivings concerning late abortions and somewhat fewer regarding surgical abortions. In general, religious belief did not influence midwives' views of TOP. Those midwives who had themselves had an abortion reported fewer misgivings about late abortions than those without personal experience of TOP.