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Walking on a tightrope—Caring for ambivalent women considering abortions in the first trimester

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  • Marianne Kjelsvik
  • Ragnhild J. Tveit Sekse
  • Asgjerd Litleré Moi
  • Elin M. Aasen
  • Eva Gjengedal

Abstract

Aims and objectives To improve the understanding and competence of health personnel when caring for ambivalent pregnant women, the aim of this study was to explore the experiences of encountering women who are unsure whether to complete or terminate pregnancy. Background Feelings of ambivalence are present in a significant number of women preparing for abortions and may challenge the provision of health care. Health personnel have reported an ideal to be nonjudgemental and supportive. Insufficient attention has been directed to the experiences of health personnel who prepare women for abortions in gynaecological units. Design Qualitative design with a hermeneutic‐phenomenological approach. Methods Focus group interviews were conducted with health personnel from four gynaecological outpatient clinics and wards in Norway (n = 20). Results The health personnel felt responsible for contributing to patient well‐being. This demanded focused attention towards all women being prepared for abortions and meant a consciousness and balancing act towards revealing, handling and being involved in the woman's potential unsureness without influencing her decision. When involved, the health personnel risked being confronted with their own vulnerabilities and values. Conclusions The health personnel tried to balance their care and support without influencing the woman's decision. Although they viewed the women as fully autonomous and responsible, they became personally involved, to varying degrees, in the uncertainty and were faced with their own vulnerabilities and values. They lacked a possibility for immediate debriefing and regular counselling after complicated consultations. Relevance to clinical practice Knowledge of the experiences of health personnel can provide input for professional development at gynaecological departments. These findings contribute to discussions about what information should be given and whether the woman's feelings should be discussed in preparation for an abortion. The ability of health personnel to discuss subjects related to ethically challenging encounters with women who are considering abortions should be established, namely, professional education and workshops at the national level and small groups with counselling and case study discussions at hospitals.

Suggested Citation

  • Marianne Kjelsvik & Ragnhild J. Tveit Sekse & Asgjerd Litleré Moi & Elin M. Aasen & Eva Gjengedal, 2018. "Walking on a tightrope—Caring for ambivalent women considering abortions in the first trimester," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(21-22), pages 4192-4202, November.
  • Handle: RePEc:wly:jocnur:v:27:y:2018:i:21-22:p:4192-4202
    DOI: 10.1111/jocn.14612
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    References listed on IDEAS

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    1. Harris, Lisa Hope & Debbink, Michelle & Martin, Lisa & Hassinger, Jane, 2011. "Dynamics of stigma in abortion work: Findings from a pilot study of the Providers Share Workshop," Social Science & Medicine, Elsevier, vol. 73(7), pages 1062-1070.
    2. Joffe, C., 2013. "The politicization of abortion: And the evolution of abortion counseling," American Journal of Public Health, American Public Health Association, vol. 103(1), pages 57-65.
    3. Martin, Lisa A. & Hassinger, Jane A. & Debbink, Michelle & Harris, Lisa H., 2017. "Dangertalk: Voices of abortion providers," Social Science & Medicine, Elsevier, vol. 184(C), pages 75-83.
    4. Cheng‐Fang Yang & Hui‐Lian Che & Hsin‐Wan Hsieh & Shu‐Mei Wu, 2016. "Concealing emotions: nurses' experiences with induced abortion care," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(9-10), pages 1444-1454, May.
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    1. Lydia Mainey & Catherine O’Mullan & Kerry Reid‐Searl & Annabel Taylor & Kathleen Baird, 2020. "The role of nurses and midwives in the provision of abortion care: A scoping review," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(9-10), pages 1513-1526, May.
    2. Yoko Ueno & Mayumi Kako & Mitsuko Ohira & Hitoshi Okamura, 2020. "Shared decision‐making for women facing an unplanned pregnancy: A qualitative study," Nursing & Health Sciences, John Wiley & Sons, vol. 22(4), pages 1186-1196, December.
    3. Mills, Lisa & Watermeyer, Jennifer, 2023. "A meta-ethnography on the experience and psychosocial implications of providing abortion care," Social Science & Medicine, Elsevier, vol. 328(C).

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