Bakgrund: Barnmorskor och sjuksköterskor världen över möter och vårdar kvinnor som av olika skäl genomför en inducerad abort. Det kan vara en utmaning som kräver både kunskap och stöd för dem som arbetar inom abortvården. Syfte: Syftet med studien var att belysa barnmorskors och sjuksköterskors erfarenheter av att vårda kvinnor i samband med inducerad abort. Ordet erfarenheter innefattar upplevelser och åsikter baserat på erfarenheter. Metod: Studien genomfördes som en kvalitativ metasyntes med metaetnografi som analysmetod. Tjugosju (27) artiklar inkluderades i resultatet. Resultat: Tre huvudkategorier och tio mönster belyser barnmorskors och sjuksköterskors erfarenheter av att vårda kvinnor i samband med inducerad abort. Dessa var att göra ett bra arbete genom att vara ett stöd, att åsidosätta egna värderingar och att skapa goda upplevelser för kvinnan. Barriärer för kvalitativ abortvård i form av negativa attityder från omgivningen, brister i verksamheten, bristande preventivmedelsanvändning, egna känslor och ta emot fostret. Behov hos vårdgivarna i form av stöd och kunskap. Slutsats: Den abortsökande kvinnan är i behov av stöd och icke dömande attityder från vårdgivare. Barnmorskor och sjuksköterskor behöver ha kunskap och få stöd i arbetet med abortvård. Brist på stöd och kunskap hos barnmorskor och sjuksköterskor kan påverka attityder om kvinnors rätt till inducerad abort inom kollegiet på en arbetsplats, vilket i sin tur kan ha en inverkan på den abortsökande kvinnans omvårdnad. / Background : Midwives and nurses all over the world meet with and care for women who, for various reasons, are undergoing induced abortion. It may be a challenge that requires both knowledge and support for those working in abortion care.Objective: To describe midwives and nurses’ experiences of caring for women who undergo induced abortion. The word experience includes perceptions based on experiences. Method: The study was conducted as a qualitative metasynthesis using meta-ethnography as analysis of data. Twenty-seven (27) peer-reviewed scientific articles were included in the result. Result: Three main categories and ten different patterns highlighted the midwives and nurses' experiences of caring for women undergoing an induced abortion. These were doing a good job by being supportive, putting own values aside and with the goal to create good experiences for the woman. Barriers to qualitative abortion care included negative attitudes from the surroundings, own feelings, receiving the fetus and various issues at the abortion care clinics. The third category was the caregivers’ needs which included support and knowledge. Conclusion: The abortion-seeking woman is in need of support and non-judgmental attitudes from caregivers. Midwives and nurses need knowledge and support in the work of abortion care. Lack of support and knowledge can affect midwives and nurses’ attitudes towards induced abortion as a woman’s right, which in turn can affect the women in need of abortion care.

No description available.

An abortion, be it induced or spontaneous, can be a traumatic experience in the life of a woman and her family. Women can use abortion as a method of family planning or to end an unwanted pregnancy. On the contrary there are women who wish to have children of their own, but experience spontaneous abortion or recurrent abortion. When women go through an abortion they may experience different dimensions of side effects and symptoms. The women may experience physical symptoms such as blood loss, pain and sepsis as well as psychological symptoms such as despair, depression and grief. Studies indicate that women who have abortions do not receive the care that they require and are in need of high quality care. There is a need for a systematic synthesis of the best available evidence regarding interventions for nursing practitioners. This can be used to inform practice. This research study aim to critically review and synthesise best available evidence regarding the best nursing practices for women who have an abortion. This was done by conducting a thorough step-by-step systematic review with the following objectives: to critically review available research evidence on abortion care and to synthesise best practices for abortion care provided by nurses. This study can provide nursing practitioners with the necessary information about the best available evidence regarding abortion care provided by nurses. The information can be used to increase and improve the nursing practitioner’s knowledge and to promote and enhance future questions and research. Through the step-by-step use of the systematic review after a thorough search and screening of potentially relevant studies on nurses providing abortion care according to the inclusion and exclusion criteria, the critical appraisal and data extraction of nine final relevant studies could be used for data analysis and synthesis. Conclusion statements were drawn and later combined and synthesised, graded and evaluated to provide the current best available evidence. The research was evaluated, limitations identified and recommendations made for nursing practice, nursing education and nursing research. The overall conclusion that can be drawn is there is not enough sufficient evidence to demonstrate that abortion care such as contraceptive counselling and/or psychological follow-up care provided by nurses and/or midwives before and after an induced or spontaneous abortion is sufficient and effective in reducing recurrent abortions, reducing despair, depression and grief and improving psychological consequences and increasing contraceptive usage. More research must be done on abortion nursing care. / MCur, North-West University, Potchefstroom Campus, 2014

An abortion, be it induced or spontaneous, can be a traumatic experience in the life of a woman and her family. Women can use abortion as a method of family planning or to end an unwanted pregnancy. On the contrary there are women who wish to have children of their own, but experience spontaneous abortion or recurrent abortion. When women go through an abortion they may experience different dimensions of side effects and symptoms. The women may experience physical symptoms such as blood loss, pain and sepsis as well as psychological symptoms such as despair, depression and grief. Studies indicate that women who have abortions do not receive the care that they require and are in need of high quality care. There is a need for a systematic synthesis of the best available evidence regarding interventions for nursing practitioners. This can be used to inform practice. This research study aim to critically review and synthesise best available evidence regarding the best nursing practices for women who have an abortion. This was done by conducting a thorough step-by-step systematic review with the following objectives: to critically review available research evidence on abortion care and to synthesise best practices for abortion care provided by nurses. This study can provide nursing practitioners with the necessary information about the best available evidence regarding abortion care provided by nurses. The information can be used to increase and improve the nursing practitioner’s knowledge and to promote and enhance future questions and research. Through the step-by-step use of the systematic review after a thorough search and screening of potentially relevant studies on nurses providing abortion care according to the inclusion and exclusion criteria, the critical appraisal and data extraction of nine final relevant studies could be used for data analysis and synthesis. Conclusion statements were drawn and later combined and synthesised, graded and evaluated to provide the current best available evidence. The research was evaluated, limitations identified and recommendations made for nursing practice, nursing education and nursing research. The overall conclusion that can be drawn is there is not enough sufficient evidence to demonstrate that abortion care such as contraceptive counselling and/or psychological follow-up care provided by nurses and/or midwives before and after an induced or spontaneous abortion is sufficient and effective in reducing recurrent abortions, reducing despair, depression and grief and improving psychological consequences and increasing contraceptive usage. More research must be done on abortion nursing care. / MCur, North-West University, Potchefstroom Campus, 2014

Bakgrund: Stöd inom abortvård har en stor betydelse för att upprätthålla en professionell förhållningsätt i mötet med patienten i abortsituationen och ge fullgodvård. Syfte: Syftet med den här studien var att beskriva barnmorskors och sjuksköterskors behov av stöd inom abortverksamheten. Metod: Kvalitativa semistrukturerade intervjuer genomfördes med sjuksköterskor och barnmorskor på en svensk kvinnoklinik för att uppnå studiens syfte. Resultat: Resultatet visade att behoven av stöd skiftade, beroende på vårdpersonalens olika utbildningar, arbetslivserfarenheter och personliga egenskaper. Behoven av stöd kunde innefatta kunskap, emotionellt stöd och etisk reflektion. Samspel i vårdteamet som består av gynekologer, barnmorskor, sjuksköterskor och kuratorer var viktigt för att kunna skapa bästa möjliga arbetsmiljö. Förutom grundutbildning som sjuksköterska eller barnmorska skulle behövas mer specifik utbildning inom abortvård. / Background: Support in abortion care has a great significance for maintaining a professional approach at the meeting with the patient in abortion situation and provide professional care. Aim: The aim of this study was to describe midwives and nurses' needs for support in abortion activities. Method: Qualitative semi-structured interviews were conducted with nurses and midwives at the Swedish women's clinic to achieve the objectives of the study. Findings: The results showed that the needs of aid shifted, depending on the health care professionals of different education, work experience and personal qualities. The need for support could include knowledge, emotional support and ethical reflection. Interaction of the treatment team consisting of gynecologists, midwives, nurses and counselors were important in order to create the best possible working environment. In addition to initial education as a nurse or midwife would need more specific training in abortion care.

Philosophiae Doctor - PhD / The prevention of abortion related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, abortion is not legal in Nigeria and Nigerian women, especially adolescents, are often unable to obtain adequate post-abortion care services due to a variety of reasons. A review of literature shows that adolescent PAC patients receive worse care than older women seeking PAC services. There is widespread recognition of the need to overcome these barriers and make it easier for women to obtain the PAC services they need. Therefore, overall aim of this research study was to provide empirical information on the barriers and challenges to adolescents' PAC and develop a policy document to inform reproductive health services for Nigerian hospitals. To develop this policy document, the study specifically sought to assess knowledge of reproductive-health and related post-abortion care services among health care providers; describe the adolescents' perception of post-abortion care received; determine the service providers' perspectives on adolescents' post-abortion care challenges and barriers; analyze the challenges and barriers faced by adolescents in obtaining post-abortion care services; explore ways in which the knowledge about challenges and barriers to adolescents' post-abortion care can be used to inform policy; develop policy document and make recommendations in key areas to improved PAC services in Nigeria as part of working towards improving reproductive health services.

Background: Despite proven efficacy, Manual Vacuum Aspiration (MVA) use for incomplete abortions is low in the Swaziland setting, including Raleigh Fitkin Memorial (RFM) Hospital. Uncertainty in the costs implications of introducing MVA to replace Dilatation and Curettage (D&C) is the major hindrance to change. This study aimed to evaluate the cost-effectiveness of introducing MVA as an evacuation method for first trimester incomplete miscarriages as well as assess the implications of the introduction of MVA to the entire post-abortion care budget at RFM Hospital. Methods: The methods comprised cost-effectiveness and budget impact analyses from a healthcare perspective based on a theoretical cohort. Clinical outcomes data for procedures were obtained from relevant literature. Costs were collated from prospective suppliers and then compared for the two treatment modalities. Future numbers of annual evacuations were extrapolated from previous annual figures. First trimester miscarriages were in turn extrapolated from proportions found in previous studies. Total budgets were calculated under the current scenario, as well as if MVA had to be introduced. Results: With initial capital costs of ZAR11 093.00, introduction of MVA for first trimester incomplete abortions will cut post-abortion care costs by 34.7%. MVA would cost ZAR819.86 per procedure while D&C costs ZAR1 255.40 per procedure. An estimated 26 MVA procedures done instead of D&C will compensate for the initial capital investment. Introduction of MVA into the post-abortion care programme will save the hospital about ZAR516 115.30 annually, with at least similar clinical outcomes compared to D&C. Conclusions: MVA should be considered as the first option in first trimester post abortion care. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / Clinical Epidemiology / unrestricted

Bakgrund: I Sverige utförs ett stort antal aborter varje år. I barnmorskans kompetensområde ingår det att ge kvinnor vård vid abort. Tidigare forskning beskriver att ju senare abort desto svårare upplevs det för både kvinnan och barnmorskan. Det finns många tidigare studier om kvinnors upplevelser av abortvård, desto mindre finns beskrivet om barnmorskans upplevelser. Syfte: Syftet med arbetet var att beskriva barnmorskors erfarenheter av abortvård på sjukhus. Metod: Arbetet utgick från en kvalitativ design med induktiv ansats. Materialet baseras på semi-strukturerade individuella intervjuer med 11 barnmorskor. Datan analyserades med kvalitativ innehållsanalys. Resultat: I resultatet framträdde fyra kategorier: Att sätta kvinnan i centrum, ett känsloladdat arbete, att arbeta professionellt och önskan om en bättre abortvård. Kategorierna bestod av 13 subkategorier: Att se individen, att stödja kvinnan, att ge information, att vara närvarande, att göra någonting betydelsefullt, utmaningar i abortvård, att värna om aborträtten, etiska dilemman inom abortvård, att lägga egna värderingar åt sidan, att vara i behov av stöd, att lindra smärta, behov av bättre smärtlindring och att ha abortvård på egen avdelning. Slutsats: Abortvård ses som ett givande och viktigt arbete. Barnmorskornas erfarenheter var att kvinnor som genomgår abort behöver stöd, närvaro, information, smärtlindring, tillgång till kurator och att alla dessa aspekter är individanpassade. / Background: A large number of abortions are performed every year in Sweden. The midwife’s area of expertise includes providing women with care in the event of an abortion. Previous research describes that the later the abortion the more difficult it is for both the woman and the midwife. There are many previous studies on women's experiences of abortion care, less is described about the experiences of the midwife. Aim: The aim of the work was to describe midwives’ experiences of abortion care. Method: The work was based on a qualitative design with an inductive approach. Based on individual semi-structured interviews conducted with eleven midwives. The interviews were analyzed with qualitative content analysis. Result: Four categories were found: to focus on the woman, an emotional work, to work professionally and the desire for better abortion care. Thirteen subcategories were created and formed the categories. Conclusion: Abortion care is seen as a rewarding and important job. The midwives experience was that women who undergo abortion need support, presence, information, pain relief, access to a counselor and that all these aspects are individualised.

Aim: To investigate gynecologists’ and midwives’ views and experiences regarding work in abortion care in Sweden. Methods: Questionnaire to gynecologists (n=269) and midwives (n=258 comprising 48 questions, response 85%. The quantitative studies (articles I-III) were supplemented by a qualitative study (article IV), consisting of focus-group interviews with gynecologists and midwives/nurses. Results: From the questionnaire studies it was apparent that all the gynecologists had worked in abortion care, whilst not all midwives had done so. The male gynecologists were older than both their female colleagues and the midwives; they had most years of experience but were now working least with abortion patients. Both groups considered it absolutely right, that Sweden have legal abortion and that the law was being followed. Most thought that women should be allowed to have an abortion even after they had felt fetal movements. The midwives were generally somewhat more restrictive than the gynecologists. Half of all thought that the work with abortion patients brought something positive with it. Those having worked longest and most extensively, especially during the previous year were most liberal. Both groups felt that there was a difference between working with surgical and late abortions compared with medical abortions. One in four had had misgivings when involved in surgical and medical abortions, and one in two with abortions after the 18th week. All were positive about the transition to medical abortions, and roughly two thirds of the midwives thought that the primary care sector should be able to take care of these, whereas less than half of the gynecologists thought this. The majority considered it important to receive further and continuing professional development and ongoing guidance. From the focus-group interviews it was clear that the experiences of the gynecologists were largely connected with the technical development of abortion methods and those of the midwives/nurses with improved pain relief. The work was sometimes described in paradoxical terms and was occasionally experienced as frustrating, especially in connection with repeat abortions. Neither of the two groups, however, had had any doubts about participating in abortion. The gynecologists described how women now expected to get an abortion, whereas previously they had asked for one. The midwife/nurse group maintained that the meetings with the women had become considerably more frequent. The interaction between the two professional groups was marked by great trust in each other’s professional competence. Conclusions: Gynecologists and midwives working in abortion care support Swedish abortion legislation and have no doubts about participating in abortions, despite the fact that they have frequently experienced complex and difficult work situations. The character of the work is experienced as contradictory and frustrating, but also as challenging and rewarding. The awareness that the two professional groups have of the importance of continuing professional development and ongoing guidance should be acted on. Furthermore, their collective views and experiences should be made use of, so that abortion care can be developed, not only in order to promote women’s health, but also to improve the work environment for the abortion staff.

Syfte: Studiens syfte var att belysa sjuksköterskors erfarenhet av abortvård i den offentliga vården i provinserna Neuquén och Río Negro, Argentina. Bakgrund: Sjuksköterskor som arbetar i primärvården möter kvinnor i behov av abort men på grund av den restriktiva lagstiftningen beror vården som erbjuds på den enskilda sjukvårdspersonalen. Abort är olagligt i Argentina, med några få undantag, och även om sjukvårdspersonal är skyldig att erbjuda eftervård vid abort så är illegala aborter den vanligaste orsaken till mödradödlighet i landet. Metod: En kvalitativ studiedesign med semi-strukturerade intervjuer med sju sjuksköterskor, som valdes genom ändamålsenligt urval. Insamlad data analyserades genom Philip Burnards metod för innehållsanalys.Resultat: Analysen resulterade i fyra kategorier; Relationen mellan sjuksköterska och patient, Betydelsen av stöd och kunskap för att vårda, Sjuksköterskans inställning till abort och förebyggande metoder och Upplevelsen av hinder i abortvården. Varje kategori delades in i två underkategorier. Slutsats: Sjuksköterskornas erfarenhet av för- och eftervård vid abort skiljde sig åt beroende på deras bakgrund, arbetsplats och inställning till abort. Flera sjuksköterskor kände sig begränsade av den restriktiva lagstiftningen, brist på kunskap och stöd från kollegor. Genom att utbilda sig själva och skapa nätverk med annan hälso- och sjukvårdspersonal så kunde många av sjuksköterskorna erbjuda vård till kvinnor i behov av abort eller eftervård. / Aim: The aim of the study was to illuminate the experiences of registered nurses attending women in pre- and/or post-abortion care in the public health sector in the provinces of Neuquén and Río Negro, Argentina.Background: Nurses working in primary care are receiving women in need of abortion but due to the restrictive law the care provided depends on the individual health professional. Abortion is illegal in Argentina with few exceptions and even though health professionals in the public health sector are obliged to provide post-abortion care clandestine abortion is the major cause of maternal mortality. Methods: A qualitative research design involving semi-structured interviews with seven nurses selected by purposive sampling. The collected data was analyzed using the method of content analysis outlined by Philip Burnard.Results: Four categories emerged from the analysis; Nurse-patient relationship, Nurses approach to abortion and preventive measures, Significance of support and knowledge in providing care and Experiencing obstacles in abortion care. Each category was divided into two subcategories. Conclusion: The nurse’s experiences of pre- and post-abortion care varied due to their background, workplace and attitude on abortion. Several nurses felt limited by the restrictive law and lack of knowledge and support from co-workers. However by educating themselves and creating networks with other health professionals many nurses were accompanying women in need of abortion or post-abortion care.