Mattison C A, Perrault V, Hibbert A, Pittson F, Robinson J
Research Affiliate, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Director, Insight Research & Policy Inc., Guelph, Canada. Correspondence:
Midwifery Technical Expert, Canadian Association of Midwives, Montreal, Canada.
Sex Reprod Health Matters. 2025 Dec;33(1):2548657. doi: 10.1080/26410397.2025.2548657. Epub 2025 Sep 15.
Midwives possess the skills and competencies required to provide abortion care in Canada, yet their role is constrained in health systems. They are well suited to address barriers to abortion access related to geographical and social inequities, which deprive many Canadians of essential healthcare and impede reproductive justice. To address current gaps, this study explores midwives' experiences providing abortion care in Canada. Qualitative data were collected from 25 in-depth interviews and three focus group discussions with midwives between August and December 2023. Using reflexive thematic analysis, we explored how midwives work in communities to provide or work toward providing abortion care, including health system facilitators, barriers, and their values, needs, and preferences for implementation. Findings highlight the barriers midwives face, including regulatory restrictions and a lack of flexible funding arrangements. Despite these challenges, midwives are leveraging their skills to advance reproductive justice, offering culturally safe, client-centred abortion care to underserved populations, including uninsured individuals. The study also identifies facilitators, such as applying midwifery values and philosophies to provide the midwifery model of abortion care. This research contributes to the growing body of knowledge on midwifery and abortion care, advocating for the removal of regulatory and funding barriers that limit midwives' potential to provide comprehensive sexual and reproductive healthcare. The findings have significant implications for policymakers and health system leaders in Canada and beyond, calling for the optimisation of midwives' roles to improve access to abortion care and advance reproductive rights globally.
在加拿大，助产士具备提供堕胎护理所需的技能和能力，但其在卫生系统中的作用受到限制。她们非常适合解决与地理和社会不平等相关的堕胎服务获取障碍，这些不平等使许多加拿大人无法获得基本医疗保健，并阻碍了生殖正义。为了填补当前的空白，本研究探讨了加拿大助产士提供堕胎护理的经历。2023年8月至12月期间，通过对25名助产士进行深入访谈和三次焦点小组讨论收集了定性数据。我们采用反思性主题分析方法，探讨了助产士如何在社区中开展工作以提供或努力提供堕胎护理，包括卫生系统的促进因素、障碍以及她们对实施的价值观、需求和偏好。研究结果突出了助产士面临的障碍，包括监管限制和缺乏灵活的资金安排。尽管存在这些挑战，助产士正在利用她们的技能推进生殖正义，为包括未参保者在内的服务不足人群提供具有文化安全性、以客户为中心的堕胎护理。该研究还确定了促进因素，例如应用助产士的价值观和理念来提供助产士堕胎护理模式。这项研究为有关助产和堕胎护理的知识体系增添了内容，倡导消除限制助产士提供全面性与生殖健康护理潜力的监管和资金障碍。研究结果对加拿大及其他地区的政策制定者和卫生系统领导者具有重要意义，呼吁优化助产士的角色，以改善堕胎护理的可及性并在全球推进生殖权利。
