Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services
Objective: To describe successes and highlight remaining challenges in the establishment of hospital-based abortion services after legal change in the Republic of Ireland. Methods: We conducted a mixed-methods study on the implementation of abortion policy in Ireland. In this manuscript, we present...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | SSM: Qualitative Research in Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266732152200052X |
| _version_ | 1811294855505117184 |
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| author | Bianca M. Stifani Joanna Mishtal Wendy Chavkin Karli Reeves Lorraine Grimes Dyuti Chakravarty Deirdre Duffy Mark Murphy Trish Horgan Mary Favier Antonella Lavelanet |
| author_facet | Bianca M. Stifani Joanna Mishtal Wendy Chavkin Karli Reeves Lorraine Grimes Dyuti Chakravarty Deirdre Duffy Mark Murphy Trish Horgan Mary Favier Antonella Lavelanet |
| author_sort | Bianca M. Stifani |
| collection | DOAJ |
| description | Objective: To describe successes and highlight remaining challenges in the establishment of hospital-based abortion services after legal change in the Republic of Ireland. Methods: We conducted a mixed-methods study on the implementation of abortion policy in Ireland. In this manuscript, we present the results from a qualitative analysis of in-depth interviews conducted with hospital-based providers, service users, and key informants. We used Dedoose software to conduct a thematic analysis of the data. Results: We report findings from interviews with 28 obstetrician gynecologists, midwives, psychiatrists, anesthesiologists, and nurses; a subset of 7 service users who sought care in hospitals; and 27 key informants. In this analysis, we describe how key themes that pertain to information, capacity and power, facilitated and hindered the implementation of hospital-based abortion services. We found that individual champions are key to establishing the service, but their motivation is not always sufficient to integrate abortion into existing clinical services, and conscientious objection is a persistent barrier to expanding abortion services. The main challenges highlighted here are lack of abortion provision at some hospitals and limited access to surgical abortion at most hospitals due to provider-level, logistical, and infrastructure barriers. Conclusions: This study presents new information on how abortion policy is implemented on the ground in hospital settings. Its findings can inform public health officials and providers in Ireland and other countries wishing to establish abortion services. |
| first_indexed | 2024-04-13T05:23:46Z |
| format | Article |
| id | doaj.art-3260c770c66c4a5cad480b98c47d8fa9 |
| institution | Directory Open Access Journal |
| issn | 2667-3215 |
| language | English |
| last_indexed | 2024-04-13T05:23:46Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj.art-3260c770c66c4a5cad480b98c47d8fa92022-12-22T03:00:40ZengElsevierSSM: Qualitative Research in Health2667-32152022-12-012100090Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based servicesBianca M. Stifani0Joanna Mishtal1Wendy Chavkin2Karli Reeves3Lorraine Grimes4Dyuti Chakravarty5Deirdre Duffy6Mark Murphy7Trish Horgan8Mary Favier9Antonella Lavelanet10Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA; New York Medical College / Westchester Medical Center, Valhalla, NY, USA; Corresponding author. 19 Bradhurst Avenue, Suite 2700S, Hawthorne, NY, 10532, USA.Department of Anthropology, University of Central Florida, Orlando, FL, USAColumbia University Mailman School of Public Health, New York, NY, USACollege of Medicine, University of Central Florida, Orlando, FL, USASocial Science Institute, Maynooth University, IrelandSchool of Sociology, University College Dublin, IrelandDepartment of Social Work and Social Care, Manchester Metropolitan University, UKEldon Family Practice, Dublin, IrelandBroadlane Family Practice, Cork, IrelandDoctors for Choice, Cork, Ireland; Southern Task Force for Abortion and Reproductive Topics, Cork, IrelandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, SwitzerlandObjective: To describe successes and highlight remaining challenges in the establishment of hospital-based abortion services after legal change in the Republic of Ireland. Methods: We conducted a mixed-methods study on the implementation of abortion policy in Ireland. In this manuscript, we present the results from a qualitative analysis of in-depth interviews conducted with hospital-based providers, service users, and key informants. We used Dedoose software to conduct a thematic analysis of the data. Results: We report findings from interviews with 28 obstetrician gynecologists, midwives, psychiatrists, anesthesiologists, and nurses; a subset of 7 service users who sought care in hospitals; and 27 key informants. In this analysis, we describe how key themes that pertain to information, capacity and power, facilitated and hindered the implementation of hospital-based abortion services. We found that individual champions are key to establishing the service, but their motivation is not always sufficient to integrate abortion into existing clinical services, and conscientious objection is a persistent barrier to expanding abortion services. The main challenges highlighted here are lack of abortion provision at some hospitals and limited access to surgical abortion at most hospitals due to provider-level, logistical, and infrastructure barriers. Conclusions: This study presents new information on how abortion policy is implemented on the ground in hospital settings. Its findings can inform public health officials and providers in Ireland and other countries wishing to establish abortion services.http://www.sciencedirect.com/science/article/pii/S266732152200052XAbortionTermination of pregnancyPolicy implementationContextual interaction theoryMotivationInformation |
| spellingShingle | Bianca M. Stifani Joanna Mishtal Wendy Chavkin Karli Reeves Lorraine Grimes Dyuti Chakravarty Deirdre Duffy Mark Murphy Trish Horgan Mary Favier Antonella Lavelanet Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services SSM: Qualitative Research in Health Abortion Termination of pregnancy Policy implementation Contextual interaction theory Motivation Information |
| title | Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services |
| title_full | Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services |
| title_fullStr | Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services |
| title_full_unstemmed | Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services |
| title_short | Abortion policy implementation in Ireland: successes and challenges in the establishment of hospital-based services |
| title_sort | abortion policy implementation in ireland successes and challenges in the establishment of hospital based services |
| topic | Abortion Termination of pregnancy Policy implementation Contextual interaction theory Motivation Information |
| url | http://www.sciencedirect.com/science/article/pii/S266732152200052X |
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