It's about finding a balance…exploring conscientious objection to abortion with UK midwives

BACKGROUND: Despite the right for health professionals to abstain from providing abortion services existing for over 50 years, literature on conscientious objection to abortion scarcely mentions midwives. In addition, little empirical research has been carried out concerning midwives' views surrounding what constitutes participation in abortion and in turn, what areas of care they can withdraw from. AIM: To explore midwives' beliefs regarding the extent of and limitations to the exercising of their legal right to objection to abortion on conscience grounds. DESIGN: Qualitative study with 17 midwives in Glasgow and Liverpool, UK. METHOD: Face to face semi-structured interviews, transcribed verbatim and analysed using a thematic analysis and Human Rights framework for midwifery care. FINDINGS: The extent of and limitations to CO to abortion-related care was reflected in four themes: respecting and protecting, making informed decisions, providing non-discriminatory care and experience and culture. There was an overriding sense of support for midwives to be able to exercise their right to conscientious objection, how this is operationalised in practice however continues to be fraught with complexity, which in turn poses constant challenges to midwives who object, their colleagues and managers. CONCLUSIONS: Midwives' beliefs regarding the exercising of their legal right to object to abortion-related care on conscience grounds can be summarized in the challenge of "finding a balance". A national picture of how to accommodate CO to abortion is needed, so that all midwives can continue to give optimal care to women and receive it themselves, within a human rights framework.