Experiences of midwives and nurses when implementing abortion policies: A systematic integrative review

Carvajal, Bielka; White, Helen K.; Brooks, Jane; Thomson, Ann; Cooke, Alison

doi:10.1016/j.midw.2022.103363

Cited by 9 publications

(3 citation statements)

References 56 publications

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“…Abortion care is an extremely sensitive issue influenced by a number of cultural, religious, social factors. 9 A previous study in Southern Thailand showed that while most nurses can identify conditions where abortion would be legal under the previous law, only a fifth were knowledgeable about the reformed, less restricted abortion law. 10 Religious context also plays a role as Muslim and Buddhist nurses have differing attitudes toward safe abortion care.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion

Uaamnuichai

Chuchot

Phutrakool

et al. 2023

INQUIRY

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In 2021, Thailand decriminalized abortions to allow for legal abortions on request up to 12 weeks’ gestation and conditionally up to 20 weeks’ gestation, or in the case of sexual assault, maternal mental or physical harm, or fetal abnormality. We intend to say that healthcare practitioners’ positive attitudes toward abortion will destigmatize abortion for both themselves and their patients. We explored the knowledge, attitudes, and intended practices of nursing students toward safe abortion practices in light of the recent law reform. This was a cross-sectional study using a self-administered questionnaire. The questionnaire consisted of 4 parts: a demographic information questionnaire; and measures to assess their knowledge, moral attitudes, and intended practice regarding safe abortion care. Questionnaires were sent to 206 nursing students who had completed the Midwifery and Maternal-Newborn Nursing rotation in Bangkok, Thailand. The survey response rate was 90.8%. Mean (standard deviation) knowledge score was 6.72 (1.86) out of 10. Buddhist students were more likely to have a positive attitude toward abortions. Most students intended to practice safe abortions in pregnancies that affect maternal physical or mental health, or in pregnancies that resulted from unlawful sexual contact. Students were more ambivalent toward abortion practices for socioeconomic reasons. Better knowledge of abortion legislation was associated with a more positive attitude toward abortions and safe abortion practice intention. Approximately 1 year after the abortion law reform in Thailand, nursing students had incomplete knowledge of the amendment. Most students were inclined to provide abortion care services for certain conditions.

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Section: Introductionmentioning

confidence: 99%

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion

Uaamnuichai

Chuchot

Phutrakool

et al. 2023

INQUIRY

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“…Qualitative research from Denmark and Sweden has reported how midwives perform “rituals” such as wrapping the aborted foetus in cloth, offer the chance to say “goodbye”, and recognise the couple as parents [ 61 , 62 ]. Provision of LTOP-related care by midwives may be associated with occupational stigma and increased likelihood of burnout [ 63 ]. Here, the TRCs serve the function of mitigating the impact on midwives’ wellbeing by ensuring that the timing of the LTOP was appropriate and that there was staffing capacity, which may in part be influenced by the willingness of staff to be involved.…”

Section: Discussionmentioning

confidence: 99%

‘The tabloid test’: a qualitative interview study on the function and purpose of termination of pregnancy review committees in Victoria, Australia

et al. 2023

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Background Termination of pregnancy (TOP) is not an uncommon procedure. Availability varies greatly between jurisdictions; however, additional institutional processes beyond legislation can also impact care and service delivery. This study serves to examine the role institutional processes can play in the delivery of TOP services, in a jurisdiction where TOP is lawful at all gestations (Victoria, Australia). As per the Abortion Law Reform Act 2008, TOPs post-24 weeks require the approval of two medical practitioners. However, in Victoria, hospitals that offer post-24 week TOPs generally require these cases to additionally go before a termination review committee for assessment prior to the service being provided. These committees are not stipulated in legislation. Information about these committees and how they operate is scarce and there is minimal information available to the public. Methods To trace the history, function, and decision-making processes of these committees, we conducted a qualitative interview study. We interviewed 27 healthcare professionals involved with these committees. We used purposive sampling to gain perspectives from a range of professions across 10 hospitals. Interviews were transcribed verbatim, identifying details removed and inductive thematic analysis was performed. Results Here, we report the three main functions of the committees as described by participants. The functions were to protect: (1) outward appearances; (2) inward functionality; and/or, (3) service users. Function (1) could mean protecting the hospital’s reputation, with the “Herald Sun test”—whether the TOP would be acceptable to readers of the Herald Sun, a tabloid newspaper—used as a heuristic. Function (2) related to logistics within the hospital and protecting the psychological wellbeing and personal reputation of healthcare professionals. The final function (3) related to ensuring patients received a high standard of care. Conclusions The primary functions of these committees appear to be about protecting hospitals and clinicians within a context where these procedures are controversial and stigmatized. The results of this study provide further clarity on the processes involved in the provision of TOPs at later gestations from the perspectives of the healthcare professionals involved. Institutional processes beyond those required by legislation are put in place by hospitals. These findings highlight the additional challenges faced by patients and their providers when seeking TOP at later gestations.

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“…Ethical dilemmas related to obstetrics and gynecology may also be due to age-old practices such as female genital mutilation, consanguineous marriages, adolescent marriage and pregnancy, and the termination of pregnancy for medical and non-medical reasons, or due to modern technologies such as sex selection, choice of delivery methods, conception methods, surrogacy, egg donations [4], prenatal diagnosis [5], selective abortions [6], and the use of genetic information [7]. In these situations, medical knowledge alone will potentially not enhance the decision-making skills.…”

Section: Introductionmentioning

confidence: 99%

Attitudes toward Medical Ethics among Obstetricians and Gynecologists in Saudi Arabia: An Exploratory Survey

Alahmad,

Althagafi

2023

Healthcare

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Ethics is an important aspect of medical care. The purpose of this study was to investigate the attitudes of obstetricians and gynecologists towards various ethical issues and ethical principles, and their satisfaction with their knowledge, understanding, and problem-solving skills regarding ethical issues. Methods: A cross-sectional survey was conducted among the working OB/GYNs in Saudi Arabia from various hospitals in Saudi Arabia between May 2020 and August 2020. A link to the three-point Likert scale questionnaire was mailed to 1000 OB/GYNs working in various hospitals. The data were analyzed using inferential statistics. The quantitative data were expressed as absolute numbers and percentages. Results: A total of 391 out of 1000 OB/GYNs responded. Most of the respondents were female OB/GYNs (65%), most of them were working in tertiary government hospitals (63%), and most were educated in bioethics (62%). About 80.3% of the respondents considered ethics important, and there was a low satisfaction rate with their knowledge (26%), understanding (38.6%), and problem-solving skills (35.8%) related to ethical issues. Conclusions: The obstetricians and gynecologists considered ethics an important aspect of daily practice but lacked the skills and knowledge to deal with ethical issues. The level of satisfaction with practice ethics was very low. Despite the fact that most of them had undergone bioethics education, most of them expressed the need for ethics training. Theoretical ethics education seemingly did not increase competence in resolving ethical issues, whereas experience did. The workplace had a strong correlation with the employee’s attitude toward ethical issues, principles, and satisfaction with their knowledge and skills in resolving ethical issues. The ethics curriculum needs to be structured in a more effective way to improve competence in dealing with ethical challenges in daily practice.

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Experiences of midwives and nurses when implementing abortion policies: A systematic integrative review

Cited by 9 publications

References 56 publications

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion

‘The tabloid test’: a qualitative interview study on the function and purpose of termination of pregnancy review committees in Victoria, Australia

Attitudes toward Medical Ethics among Obstetricians and Gynecologists in Saudi Arabia: An Exploratory Survey

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