Is there stigma for working on abortion field? The care provider's perspetive
ESC Congress Library. Carmo Bombas T. May 11, 2018; 208259; ESC280
Dr. Teresa Alexandra Carmo Bombas
Dr. Teresa Alexandra Carmo Bombas
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Abstract
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Introduction: Women who experience abortion often fears judgement and discrimination. However, recent data show that abortion providers present the same fears from society, friends and pairs. In Portugal, abortion is performed mainly on National Health System Services (NHS),  near of 18000 abortions per year, but paradoxically there are few profissionals working on the field. Abortion provider's stigma can be one of the reasons for the gap on training and a future barrier on acess to safe abortion.  Objectives: Quantify and qualify abortion providers' perceptions of stigma. Design and methods: Abortion stigma perceived by abortion health care providers was evaluated through an anonymous 35-item Abortion Provider Stigma Survey, which measures global stigma and its specific dimensions: disclosure management, internalized states, judgement, social support and discrimination. Stigma classification was considered as low, moderate and high. The survey was validated by Kaiser-Meyer-Olkin test. Score analysis was performed by using Fisher's exact test. Significance was set for p < 0 .05. Results: A total of 194 health care providers were included: 39.2% physicians, 29.9% nurses, 14.9% technical assistants, 7.2% psychologists, 6.2% operational assistants, and 2.6% social assistants. Although abortion providers claim that stigma decreased in the last 10 years, still 55.7% feel stigma. Stigma level for the dimension judgement was higher for physicians (1.3% scored high stigma; 33.3% moderate) whereas it was determined lower for the other job categories (p = 0.016). Stigma for the dimension social support depended on time of abortion practice: high stigma - highest for 5-9 years of practice (11.8%); moderate stigma - highest for more than 10 years of practice (40.5%); p = 0.021). Stigma score for the dimension disclosure management was determined higher for male professionals (16.7%) vs. females (0.7%) (p = 0.001). Total stigma did not depend on age, gender, time of abortion practice or job category as scores were predominantly low. However, when mean values were compared, total stigma was significantly different between physicians (most stigma) and psychologists (less stigma) (p = 0.009). When professionals were asked if there is stigma against women who decide for abortion, 75.3% responded affirmatively. Conclusions: This study reinforces that abortion stigma remains an important issue. Abortion providers stigma is underestimated. This stigma can cause negative impact on providers motivation, which can reduce optimization of hard and soft skills acquisition and ultimately limit the quality of healthcare.
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