Crossing Complex Realities: Nurses' and Midwives' Provision of Abortion Care Amidst Gender-Based Violence in Pakistan

Abstract

Background: Gender-based violence (GBV) poses a significant public health challenge globally, with Pakistan being no exception to its prevalence. In this context, women who have experienced GBV often require specialized and sensitive healthcare services, including abortion care.

Objective: This qualitative study aims to explore the experiences, challenges, decision-making processes, coping mechanisms, and patient-centered care practices of nurses and midwives providing abortion care to women who have experienced gender-based violence in Pakistan.

Methodology: Semi-structured interviews were conducted with qualified nurses and midwives working in healthcare settings where abortion care is provided. Purposive sampling was used to recruit participants from diverse geographical locations and healthcare facilities to ensure a representative sample. The interview guide focused on participants' experiences, challenges, ethical considerations, and coping mechanisms while providing abortion care in the context of gender-based violence. The data were analyzed using thematic analysis.

Results: The findings revealed that healthcare providers faced complex challenges in delivering abortion care to women experiencing gender-based violence. These challenges included navigating legal complexities, addressing stigma, and providing patient-centered care in the face of cultural and societal norms. Coping mechanisms employed by providers ranged from seeking peer support to accessing mental health resources to manage the emotional toll of their work. Ethical considerations were central to the decision-making process, emphasizing the importance of informed consent, autonomy, and confidentiality in care provision.

Conclusion: The study highlights the unique challenges and ethical dilemmas faced by healthcare providers in providing abortion care to women experiencing gender-based violence in Pakistan. Training and support systems, policy reforms, and patient-centered care approaches are crucial in improving reproductive healthcare services for this vulnerable population.