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How task‐sharing in abortion care became the norm in Sweden: A case study of historic and current determinants and events
Author(s) -
Endler Margit,
Cleeve Amanda,
Sääv Ingrid,
GemzellDanielsson Kristina
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13003
Subject(s) - abortion , autonomy , thematic analysis , competence (human resources) , norm (philosophy) , medicine , context (archaeology) , political science , public relations , nursing , family medicine , qualitative research , psychology , law , sociology , social psychology , pregnancy , social science , genetics , biology , paleontology
Abstract We performed a country case study using thematic analysis of interviews and existing grey and published literature to identify facilitators and barriers to the implementation of midwife‐provided abortion care in Sweden. Identified facilitating factors were: (1) the historical role and high status of Swedish midwives; (2) Swedish research and development of medical abortion that enabled an enlarged clinical role for midwives; (3) collaborations between individual clinicians and researchers within the professional associations, and the autonomy of clinical units to implement changes in clinical practice; (4) a historic precedent of changes in abortion policy occurring without prior official or legal sanction; (5) a context of liberal abortion laws, secularity, gender equality, public support for abortion, trust in public institutions; and (6) an increasing global interest in task‐shifting to increase access and reduce costs. Identified barriers/risks were: (1) the lack of systems for monitoring and evaluation; and (2) a loss of physician competence in abortion care.