Navigating a maze: Midwives' identity response to the enactment of an abortion law in Chile

Midwifery. 2024 Apr:131:103938. doi: 10.1016/j.midw.2024.103938. Epub 2024 Jan 28.

Abstract

Background: Chilean midwives have been identified as essential for successfully implementing an abortion law, a practice which could potentially be understood as contradicting their central mission. Nevertheless, to date, there has been no investigation into how Chilean midwives have incorporated induced abortion care provision into their professional identity.

Objective: To elucidate how Chilean midwives understand and provide abortion care and how they have (re)defined their professional identity to include induced abortion care. This article reports the findings of the second part of this aim.

Methods: This study was underpinned by a constructivist grounded theory methodology informed by a reproductive justice and feminist perspective. Midwives from Chile who have cared for women undergoing abortion were invited to participate in the study. After purposive and theoretical sampling, fifteen midwives were recruited.

Findings: Midwives' identity is woman-centred, with high value placed on their role protecting life. These two aspects of midwives' identity are in contradiction when providing abortion care. Midwives' identity results from and informs midwives' practice. Midwifery regulation influences both practice and identity. The model 'Navigating a maze' explains the interaction of these three elements.

Conclusion: Midwives' identity response to the enactment of the Chilean abortion law is an example of how professional identity must navigate regulation and practice to make sense of its purpose. In light of this study's findings, the current tension experienced in midwives' identity should be carefully attended to prevent adverse outcomes for midwives and the Chilean population.

Keywords: Chile; Induced abortion; Midwifery; Professional identity formation; Public policy.

MeSH terms

  • Abortion, Induced*
  • Abortion, Spontaneous*
  • Attitude of Health Personnel
  • Chile
  • Female
  • Humans
  • Midwifery* / methods
  • Nurse Midwives*
  • Pregnancy
  • Qualitative Research