Conceding and concealing judgement : implications for nurses in abortion care.

BackgroundThis study has been funded as part of a two-year post-doctoral fellowship by the Research Capacity Building Collaboration, Wales. Advances in termination of pregnancy have resulted in more terminations performed through the sole use of pharmacological agents, commonly administered by nurses. In addition, a recent House of Commons Science and Technology Committee reported and debated amending the Abortion Act (House of Commons Science and Technology Committee, 2007). This research was undertaken to examine the potential implications for nurses having more involvement in abortion.ObjectiveTo explore the affective attributes of the nurses/midwives involved in termination of pregnancy.MethodsFollowing ethical and research governance approval, a grounded theory study was undertaken in 2007. A convenience sample of 12 NHS nurses/midwives experienced in abortion services in the National Health Service in Wales, UK were interviewed using a semi-structured technique. FindingsThe data were analysed with the aid of NVivo. Through constant comparative analysis, each interview was refined in response to findings. Despite raising non-judgementality as an attribute, data showed that the nurses/midwives conceded judging the women for whom they cared. They concealed their judgements when providing care through various means such as 'keeping it back there'. On an abortion continuum, nurses were more likely to be judgemental about women seeking repeat abortions. To counteract judgements they used maxims to defend women's predicament such as 'there but for the grace of God go I'. They were keen advocates of their service recognising the women as vulnerable, stigmatised and requiring expert care. DiscusssionResults have prompted a third phase of theoretical sampling where the issues of judgementality will be further explored. Although not fully generalisable, the findings have elucidated an interesting phenomenon and are worthy of consideration by those working in abortion services internationally. ReferenceHouse of Commons Science and Technology Committee. (2007). Scientific developments relating to the abortion act 1967. In H. o. Commons (Ed.) (12th Report of the session 2006-07 ed., Vol. 1, pp. 1-93): TSO.