2025 Volume 39 Issue 1 Pages 67-78
Objective
This study aimed to explore midwives' attitudes and perceptions regarding induced abortion as well as the pain they experienced when providing care.
Subjects and Methods
A self-administered, anonymous questionnaire survey of midwives in 11 prefectures in Japan was conducted between March and September 2022. The questionnaire included questions about their backgrounds, experience of abortion care, attitudes toward hypothetical clinical scenarios, perceptions regarding induced abortion, and pain experienced during care. The chi-square test was used for the analysis, and intergroup comparisons were made when significant differences were found.
Results
A total of 571 responses to the questionnaire were collected, and 563 sets were included in the analysis. In terms of age, 28.1% of the respondents were in their 40s. The largest proportion (41.7%) of the respondents was accounted for by midwives certified 21 or more years ago. More than half of the respondents (55.4%) had provided birth assistance in 201 or more deliveries. At the time of the survey, 67.5% and 14.6% of the respondents worked in hospitals and clinics, respectively. Of the respondents, 63.1% had studied reproductive health/rights, and 74.1% had studied abortion care. From the first year of employment, 53.6% had provided first-trimester abortion care, and 36.6% provided second-trimester abortion care. As for midwives' attitudes toward hypothetical clinical scenarios, the respondents were less accepting and empathetic in cases of high school students repeating abortion due to unrestrained sexual activity and in cases of choosing abortion because correctable congenital malformations were found. Furthermore, 32.5% of the respondents answered that abortion is “a right of women/both women and men,” while 55.1% answered that “I can be neither affirmative nor negative because it depends on the situation.” During abortion care, 96.0% of the respondents felt that it was “painful,” with the most common reason being painfulness for caring about the woman, followed by painfulness for caring about the fetus and painfulness for caring about the midwife herself.
Conclusion
Midwives' attitudes and awareness toward induced abortion as well as the pain they experienced when providing care, suggest that the quality enhancement of induced abortion care in Japan requires improvements in basic midwifery education, training and the support environment to ensure that midwives' personal beliefs are respected.
