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Personal Beliefs and Professional Responsibilities: Ethiopian Midwives' Attitudes toward Providing Abortion Services after Legal Reform
Author(s) -
Holcombe Sarah Jane,
Berhe Aster,
Cherie Amsale
Publication year - 2015
Publication title -
studies in family planning
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 68
eISSN - 1728-4465
pISSN - 0039-3665
DOI - 10.1111/j.1728-4465.2015.00016.x
Subject(s) - abortion , unsafe abortion , religiosity , medicine , nursing , abortion law , developing country , family planning , family medicine , population , psychology , economic growth , social psychology , pregnancy , environmental health , genetics , economics , research methodology , biology
In 2005, Ethiopia liberalized its abortion law and subsequently authorized midwives to offer abortion services. Using a 2013 survey of 188 midwives and 12 interviews with third‐year midwifery students, this cross‐sectional research examines midwives' attitudes toward abortion to understand their decisions about service provision. Most midwives were willing to provide abortion services. This willingness was positively and significantly related to clinical experience with abortion, but negatively and significantly related to religiosity, belief that providers have the right to refuse to provide services, and care of patients from periurban as opposed to rural areas. No significant relationship was found with perceptions of abortion stigma, years of work as a midwife, or knowledge of the law. Interview data suggest complex dynamics underlying midwives' willingness to offer services, including conflicts between professional norms and religious beliefs. Findings can inform Ethiopia's efforts to reduce maternal mortality through task‐shifting to midwives and can aid other countries that are confronting provider shortages and high levels of maternal mortality and morbidity, particularly due to unsafe abortion.