“It is against my religion” The attitude of the midwife in increasing access to safe abortion care in Ghana: A qualitative study design

Abstract

Background: Unsafe abortion remains a major public health problem in spite of international convention calling for the prevention of unwanted pregnancies and the provision of safe abortion services. Standards and protocols developed by the Ghana Health Service in 2006 authorized midwives to provide early induced abortion services under the law. Objective: The purpose of the study was to understand midwives’ readiness to be involved in increasing access to legal safe induced abortion care in primary health facilities in Ghana. Methods: A qualitative research approach using semi-structured topic guide for individual indepth interviews on purposefully selected participants was adopted. The interviews were recorded on tape and analysed using content analysis approach. Results: Participants revealed various reasons behind their choice of midwifery as a profession. They emphasised on reasons such as their past experiences on maternal deaths in their community, passion for the health of pregnant women and their willingness to help reduce maternal mortalities in Ghana. Knowledge on Ghana’s abortion law was found to be generally low among the participants. They expressed different views on the provision of safe abortion services in their facility. Some felt it was against their religious belief and that it is sinful to provide abortion services, whilst others felt it was good to save the lives of women. Religion was highlighted as one of the main reasons why some participants would not provide abortion services in their facility. Conclusion: There was a realization that maternal mortality is a problem in Ghana and participants were enthuse to help reduce it. The main motivator for midwives to provide abortion services in their facility was to help reduce maternal mortality. A pronounced hindrance for midwives to provide abortion services was religion.