Objective: To explore Swedish women's experiences of clinical abortion care in relation to their need for existential support. Interviews were analysed by latent content analysis. MethodsFindings: Although the women had similar experiences of the abortion care offered, the needs they expressed differed. Swedish abortion care was described as rational and neutral, with physical issues dominating over existential ones. For some women, the medical procedures triggered existential experiences of life, meaning, and morality. While some women abstained from any form of existential support, others expressed a need to reflect upon the existential aspects and/or to reconcile their decision emotionally.Conclusion: As women's needs for existential support in relation to abortion vary, women can be disappointed with the personnel's ability to respond to their thoughts and feelings related to the abortion. To ensure abortion care personnel meet the physical, psychological, and existential needs of each patient, better resources and new lines of education are needed to ensure abortion personnel are equipped to deal with the existential aspects of abortion care.Women's existential experiences… Journal of Psychosomatic Obstetrics and Gynecology 3

Women's experiences of abortion can include existential thoughts about life, death, meaning and morality, feelings of attachment to the foetus, and the need for symbolic expression. This presents a challenge for abortion personnel, as the situation involves complex aspects over and above medical procedures and routines.

Induced abortion is as common in religious as secular cultures, but interpretations and ways to handle abortion differ. This study focuses existential aspects of abortion, in relation to a secularized context, through in-depth interviews with 24 Swedish women. Existential questions belonging to four areas were found: Life and Death, Meaning of Life, Morality and Self Image.Furthermore, four different existential strategies were found: (1) Detaching Strategies (creating distance to the pregnancy), (2) Meaning-Making Strategies (relating the abortion to one's worldview), (3) Social Strategies (sharing the abortion with others), and (4) Symbolic Strategies (expressing the experience in bodily ways). Existential questions and strategies did not imply that the woman regretted her abortion. However, while some women easily processed existential questions, others seemed to be more at loss. In a secularized country, where many people are unaccustomed to deal with existential issues, greater existential competence among abortion personnel thus might be needed.

No matter how technically developed and medically sophisticated our society becomes, in the end we are all going to die. In other words, as human beings we are, from time to time, forced to deal with situations of existential significance. Existential and spiritual questions remain relevant—even in a country where most people­ have abandoned institutional forms of religion. But how do people­ deal with these questions? Sweden continues to uphold an extreme position, from a global perspective, when it comes to religiosity and traditional values. No other country in the world has, to such a great extent, left traditional and survival values on the behalf of those based on rationality and self expression. Religious and ethnic minorities have brought new forms of piety to the Swedish scene, but secularization and religious privatization dominate. In this situation, it is important to study people’s ways of dealing with existential life situations. What do people think, feel, believe and do in the presence of the ultimate questions—when there exists no common ground for meaning-making? This article begins with an outline of the state of religion in Sweden, against the backdrop of the contemporary climate in Western culture. This is followed by an introduction to abortion in Sweden, and to abortion research of interest for this paper. Ritual participation is the next topic, leading to concepts of importance for the pilot study: existential homelessness and individualized rituals. In the rest of the article the focus is on the pilot study and a discussion of its results in relation to the existential situation in Sweden at large.

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