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Nurses consider many factors when it comes to abortion decision-making

This study found that nurses are influenced by a variety of factors when it comes to ethically challenging work, including abortion. The decision to provide abortion care may seem like a simple dichotomy — between those who do, and those who conscientiously object — but the reality is more complex.

Key Findings

The 25 nurses in this study made clinical decisions related to participation in abortion care using a multitude of perspectives.
Participants described tacking back and forth between their personal attitudes, beliefs, and feelings and their professional obligations as nurses.
Some noted the need to separate themselves from their patients, while others described using their own experiences to show empathy. This is the first study to report that nurses can hold two conflicting views at the same time.
Nurses also weighed others’ comments or perceptions in their decision-making process, including their perceptions of nursing as shared work, the stigma they faced from others, and instances of interprofessional conflict.
Before providing abortion care, many nurses felt they needed to know the background and reasons for the abortion, and not all felt capable and/or had the resources to provide this care.
Nurses also discussed challenges to establishing the parameters of nursing-patient relationships in abortion-related contexts.

Study Design

Researchers interviewed 25 Bay Area registered nurses who worked in a variety of clinical areas about their careers in nursing and work experiences. They were asked to think of a time when a woman needing an abortion was admitted to their unit and to recount that day, as well as any interactions they had with others in the context of this patient’s care.

From one respondent: “Yeah, we had a big fight about that with one nurse and myself. It was like, ‘Gee, you can take care of the murderer, the rapist, the bank executive, but you can't take care of the 21 year old, you don't know how she got pregnant, if she's got five kids at home and what her life is like...Why do you get to pick that little girl and tell her that you're not taking care of her, but your moral boundaries accept every other creep that comes in here?’ We do not make those moral distinctions. We deal with people and we say, ‘You're my patient. I'm going to do the best I possibly can for you.’”


Findings from this study could be used to develop reflexive exercises and simulations to provide a neutral space for nurses to consider and explore ethically challenging parts of their work. It is important to create opportunities for nurses to explore together their shared work in situations characterized by competing and conflicting views and beliefs, including those held within the individual.

This study, Calculus Formation: Nurses’ Decision-Making in Abortion-Related Care, was published in Research in Nursing and Health.