Biggs J. Teaching for quality learning at university..: Open University Press; 1999

Braun V, Clarke V. Using thematic analysis in psychology.. Qualitative Research in Psychology. 2006; 3:(2)77-101

British Society of Abortion Care Providers. Statement: Providing Genuine Choice.. 2020. (accessed 10 November 2020)

Coldridge L, Davies S. “Am I too emotional for this job?” An exploration of student midwives' experiences of coping with traumatic events in the labour ward.. Midwifery. 2017; 45:(2)1-6

Dennis A, Blanchard K, Bessenaar T. Identifying indicators for quality abortion care: a systematic literature review.. Journal of Family Planning for Reproductive Health Care. 2017; 43:(1)7-15

Engel GL. The need for a new medical model: a challenge for biomedicine.. Science. 1977; 196:(4286)129-136

EU. European Council and the European Parliament Directive.. 2005. (accessed 11 November 2020)

Feilzer YM. Doing mixed methods research pragmatically: implications for the rediscovery of pragmatism as a research paradigm.. Journal of Mixed Methods Research. 2010; 4:(1)6-16

Fine JB, Mayall K, Sepúlveda L. The role of international human rights norms in the liberalization of abortion laws globally.. Health and Human Rights. 2017; 19:(1)

Fullerton J, Butler MM, Aman C, Reid T, Dowler M. Abortion-related care and the role of the midwife: a global perspective.. International Journal of Women's Health. 2018; 10:751-762

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research.. BMC Medical Research Methodology. 2013; 13:(1)

Greasley P. Quantitative data analysis using SPSS: an introduction for health and social science..Maidenhead, and New York Maidenhead, and New York: McGraw-Hill Education (UK); 2008

Hojat M, Vergare MJ, Maxwell K The devil is in the third year: a longitudinal study of erosion of empathy in medical school.. Academic Medicine. 2009; 84:(9)1182-1191

International Confederation of Midwives. Essential competencies for midwifery practice.. 2019. (accessed 11 November 2020)

Kavanagh A, Wielding S, Cochrane R, Sim J, Johnstone A, Cameron S. ‘Abortion’ or ‘termination of pregnancy’? Views from abortion care providers in Scotland, UK.. BMJ Sexual Reproductive Health. 2018; 44:(2)122-127

Klingberg-Allvin M, Van Tam V, Nga NT, Ransjo-Arvindson AB, Johannsson A. Ethics of justice and ethics of care: values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview.. International Journal of Nursing Studies. 2007; 44:(1)37-46

Kolb DA. Experiential learning: experience as the source of learning and development (Vol. 1)..Englewood Cliffs, NJ: Prentice-Hall; 1984

Lee RM. Doing research on sensitive topics..London: Sage Publications Ltd; 1999 Abortion Act.. 1967. (accessed 5 November 2020)

Lukasse M, Lilleengen AM, Fylkesnes AM, Henriksen L. Norwegian midwives' opinion of their midwifery education – a mixed methods study.. BMC Medical Education. 2017; 17:(1)

Marecek J, Macleod C, Hoggart L. Abortion in legal, social, and healthcare contexts.. Feminism and Psychology. 2017; 27:(1)4-14

Maxwell B. Professional ethics education: studies in compassionate empathy..Germany: Springer Science and Business Media; 2008

McKenna L, Boyle M, Brown T Levels of empathy in undergraduate midwifery students: an Australian cross-sectional study.. Women and Birth. 2011; 24:(2)80-84

O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations.. Academic Medicine. 2014; 89:(9)1245-1251

Nursing and Midwifery Council. The code: professional standards of practice and behaviour for nurses, midwives and nursing associates.. 2018. (accessed 10 November 2020)

Nursing and Midwifery Council. Future midwife: Standards of proficiency for midwives.. 2019. (accessed 10 November 2020)

Paul M, Gemzell-Danielsson K, Kiggundu C, Namageny R, Klingberg-Allvin M. ‘Barriers and facilitators in the provision of post-abortion care at district level in central Uganda – a qualitative study focusing on task sharing between physicians and midwives’.. BMC Health Services Research. 2014; 14:(1)

Pezaro S, Clyne W, Turner A, Fulton EA, Gerada C. ‘Midwives overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on.. Women and Birth. 2016; 29:(3)e59-e66

Priaulx N. The social life of abortion law: on personal and political pedagogy.. Medical Law Review. 2017; 25:(1)73-98

Purcell C, Hilton S, McDaid L. The stigmatisation of abortion: a qualitative analysis of print media in Great Britain in 2010.. Culture, Health and Sexuality. 2014; 16:(9)1141-1155

Råheim M, Magnussen LH, Sekse RJT, Lunde Å, Jacobsen T, Blystad A. Researcher–researched relationship in qualitative research: shifts in positions and researcher vulnerability.. International Journal Of Qualitative Studies on Health and Wellbeing. 2016; 11:(1)

Regan L, Glasier A. The British 1967 Abortion Act–still fit for purpose?. The Lancet. 2017; 390:(10106)1936-1937

Ritchie J, Spencer L. Qualitative data analysis for applied policy research.. In: Bryman A, Burgess RG (eds). New York, London: Routledge; 1994

Ritchie J, Lewis J. Qualitative research practice: a guide for social science students and researchers..London, Thousand Oak: New Delhi: SAGE Publications; 2003

Robson C, McCartan K. Real world research: a resource for users of social research methods in applied settings., 4th ed. Chichester: John Wiley and Sons Inc; 2016

Abortion worldwide 2017: uneven progress and unequal access.. 2018. (accessed 5 November 2020)

Smyth D, Lane P. Abortion in modern health care: considering the issues for health-care professionals.. International Journal of Nursing Practice. 2016; 22:(2)115-120

Framework analysis: a qualitative methodology for applied policy research.. 2009. (accessed 10 November 2020)

Tey N-p, Yew S-y, Low W-y Medical students' attitudes toward abortion education: Malaysian perspective.. PLOS ONE. 2012; 7:(12)

Tshuma B, Haruzivishe C, Chipamaunga S. Abortion: a concept analysis IOSR.. Journal of Nursing and Health Science. 2018; 7:(5)20-23

Turner KL, Hyman AG, Gabriel MC. Clarifying values and transforming attitudes to improve access to second trimester abortion.. Reproductive Health Matters. 2008; 16:(31)108-116

Wellings K, Jones KG, Mercer CH The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).. The Lancet. 2013; 382:(9907)1807-1816

World Health Organization. Recommendations intrapartum care for a positive childbirth experience.. 2018. (accessed 5 November 2020)

Williams B, Brown T, Boyle M, McKenna L, Palermo C, Etherington J. Levels of empathy in undergraduate emergency health, nursing, and midwifery students: a longitudinal study.. Advances in Medical Education and Practice. 2014; 4:(5)299-306

An exploration of the perceptions of student midwives about midwifery education related to abortion

02 December 2020
Volume 28 · Issue 12



There is variation in undergraduate curriculum content related to abortion, both nationally and internationally.


To explore how student midwives perceived education related to abortion within a midwifery curriculum.


A qualitative exploratory survey design used an anonymised questionnaire to capture the perception of 60 student midwives on education related to abortion. Frequency, distribution and themes generated were synthesised using framework analysis.


A total of 45 students responded. Overall, 16 were in first year, 15 were in second year and 14 were third year students. Of those who had received education about abortion, only five (2.25%) expressed that their learning needs about the topic had been met. A total of 40% (18) had cared for women seeking abortion while in clinical placement. There were two overarching themes that were identified: education and values.


The theory of abortion did not prepare the students for practice. Standardised midwifery content is required, covering definition, process, and legal aspects of care around abortion, on international, national and local levels. Empathy was enhanced by exposure to theory or practice and a safe, reflective, educational space is essential to explore how perceptions change after exposure to the topic.

Midwives must provide individualised, culturally sensitive care to women seeking abortion in relation to decision making, eligibility for abortion, process, risks and ethical issues (International Confederation of Midwives, 2019). However, in Europe, the requirement to deliver safe practice prior to registration as a midwife does not specifically refer to abortion (EU, 2005). Nationally, standards explain there should be a focus around, ‘contraception, unintended pregnancy, and abortion’ (Nursing and Midwifery Council [NMC], 2019). Therefore, there is an element of discretion where midwifery programmes are left to decide how to include the topic in their curricula.

Midwives' practice-based experience around abortion varies and it is unknown how many student midwives in the UK are involved in that care (Klingberg-Allvin et al, 2007; Paul et al, 2014). Lukasse et al (2017) recognise that 50% of midwifery education takes place in practice and the experience has a substantial impact on student learning. However, it is difficult to align every aspect of exposure in practice to concurrent theoretical content. Therefore, midwifery programmes of education need to make judgment calls about when to place theory into the curricula to meet the developmental needs of the student midwife.

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