Cleetus Maryanne, Lazarou Mattea, Tooker Siân, Jenkinson Bec, Dean Judith A
School of Public Health, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia.
Children by Choice, Suite 3B Level 3/49 Sherwood Road, Toowong, Qld 4066, Australia.
Sex Health. 2022 Dec;19(6):491-500. doi: 10.1071/SH22059.
Termination of pregnancy (ToP) was decriminalised in Queensland, Australia, in December 2018. Although approximately 14 000 terminations are performed in Queensland annually, decriminalisation had addressed a known barrier to ToP access by supporting the legal right to access and enabling safe and regulated public pathways to ToP care. The post-decriminalised ToP experience in Queensland is unknown. Therefore, this study explored the reported reasons clients access information and support from an all-options pregnancy counselling service in Queensland with the aim of identifying the facilitators and barriers accessing ToP that remain post-decriminalisation in Queensland.
A two-part qualitative conventional and directed content analysis approach guided by the Socioecological Model was used to examine counsellor notes on interactions with clients (n =1933) between December 2018 and June 2020 at an all-options pregnancy counselling service in Queensland.
Key reasons for contacting the service were for financial assistance, ToP information, and support for decision making. Facilitators and barriers affecting ToP access interconnected across the Socioecological Model levels highlighting affordability, violence, stigma, knowledge, and information as key factors influencing ToP access post-decriminalisation in Queensland.
Inclusive multisectoral action to support reproductive autonomy is needed in Queensland. Following decriminalisation, cost, stigma, and intimate partner violence continue to impede access to safe, compassionate, and timely abortion care. Future models of care must eliminate these barriers by developing public models of service provision, investing in workforce development, fully utilising the capacity of that workforce, and creating stronger connections between sexual and reproductive health and intimate partner violence services.
2018年12月，澳大利亚昆士兰州将终止妊娠合法化。尽管昆士兰州每年约有14000例终止妊娠手术，但合法化通过支持获取终止妊娠的合法权利以及建立安全且规范的终止妊娠护理公共途径，解决了一个已知的获取终止妊娠服务的障碍。昆士兰州终止妊娠合法化后的情况尚不清楚。因此，本研究探讨了昆士兰州一家提供全方位选择的妊娠咨询服务机构中，客户获取信息及支持的报告原因，旨在确定昆士兰州终止妊娠合法化后仍存在的获取终止妊娠服务的促进因素和障碍。
采用由社会生态模型指导的两部分定性常规和定向内容分析方法，研究2018年12月至2020年6月期间昆士兰州一家提供全方位选择的妊娠咨询服务机构中咨询师与客户互动的记录（n = 1933）。
联系该服务的主要原因是寻求经济援助、获取终止妊娠信息以及获得决策支持。影响获取终止妊娠服务的促进因素和障碍在社会生态模型的各个层面相互关联，突出了可负担性、暴力、耻辱感、知识和信息是影响昆士兰州终止妊娠合法化后获取终止妊娠服务的关键因素。
昆士兰州需要采取包容性的多部门行动来支持生殖自主权。合法化后，成本、耻辱感和亲密伴侣暴力继续阻碍人们获得安全、人道且及时的堕胎护理。未来的护理模式必须通过开发公共服务提供模式、投资于劳动力发展、充分利用该劳动力的能力以及在性健康和生殖健康与亲密伴侣暴力服务之间建立更紧密的联系来消除这些障碍。
