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

Abstract

Introduction: Termination of pregnancy (ToP) service delivery in Aotearoa New Zealand occurs within a multi-dimensional system which is influenced and shaped by various philosophical, political and economic discourses, and is comprised of interconnected components. One component is the provision of counselling for women seeking a termination of pregnancy. This study aimed to explore how service managers and social work practitioners perceived how ToP services, particularly the counselling component therein, were being delivered nationally. Methods: A concurrent, multi-level, mixed-methods research design was employed in the study. 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 (DHBs) across Aotearoa New Zealand. Service managers (20) participated in interviews with a focus on capturing information about operational systems that supported or hindered the delivery of ToP and counselling services, while 26 social work and counselling practitioners participated in an electronic survey questionnaire. Qualitative data were thematically analysed and quantitative data were descriptively analysed using descriptive statistics. Findings: Results from this mixed-methods study were integrated at the level of interpretation and linkage between the methods showed that practice within ToP licensed facilities varied markedly. Specifically, nine practice and systemic variations were identified that had implications for women receiving ToP services. Existing variations across licensed facilities were signalled as disconnects between components of the service delivery system. Conclusions: Recommendations that address variations and systemic disconnects are offered to the New Zealand Abortion Supervisory Committee and Ministry of Health. Further research is suggested to obtain the perspective of service users as this was one limitation of this small exploratory study.