An investigation of the nature of termination pregnancy counselling within the current system of licenced abortion facilities

Abstract

Termination of pregnancy is a health procedure that more than 13,000 New Zealand women undertook in 2014. Termination of pregnancy (ToP) service delivery occurs within a multi-dimensional system which is influenced and shaped by various philosophical, political and economic discourse, and is comprised of interconnected components. One of these components is the provision of counselling for women seeking a termination of pregnancy. Informed by the author’s ToP counselling practice experience in a licenced facility, the study aimed to explore perceived variations in how ToP services, particularly the counselling component, were being delivered nationally. The research approach employed for this study “an investigation of the nature of ToP counselling within the current system of licenced facilities” was a concurrent multi-level mixed methodology design. Two purposively selected sample groups comprising 1) service managers responsible for the oversight of ToP service delivery, and 2) ToP counselling practitioners were recruited from 19 District Health Boards nationally. Twenty service managers participated in interviews with focus on capturing information about operational systems that supported or hindered the delivery of ToP and ToP counselling services. Twenty-six social work and counselling practitioners participated in an electronic survey questionnaire. Qualitative data was thematically analysed and quantitative data was analysed using descriptive statistics. Results from this study confirmed that variations across licenced facilities did exist. Variations were signalled as disconnects between components of the service delivery system and nine variations were identified that had implications for women receiving ToP services. Further research is suggested to obtain the perspective of service users as this was one limitation of this study. Strategies that address variations and systemic disconnects are offered by way of recommendations to the New Zealand Abortion Supervisory Committee and Ministry of Health.