Abortion counselling in South Africa: A systematic review of the research

Abstract

The purpose of this systematic review is to unearth themes, using a thematic analysis, from research written on abortion counselling in South Africa. The rationale behind this study is to contribute to a larger project that involves operationalizing guidelines for abortion counselling. Searches were conducted using Google scholar and Science Direct. A total of 17 articles were found to be of relevance to the study. Braun and Clarke's thematic analysis was applied to these articles. Six broad themes arose from the data namely: experiences of women; nurses' responses to abortion and objection to abortion services; failed contraception and repeat abortions; counselling methods: one size does not fit all; contextualizing abortion narratives and difficulties nurses face in implementing family planning. Overall, these themes were linked by a theme of ambiguity and contradiction in experiences. This was not only in-line with findings of other research in the field of abortion but further points to issues of standardization and deficits in abortion counselling guidelines. The lack of concrete guidelines may be linked with themes of nurses evaluating abortion seekers based on their own moral framework and values. Furthermore, deficits in counselling were found to be linked to barriers to access such as time constraints and structural issues. Lastly, counselling in almost all articles for analysis revealed that clinics and nurses treat counselling as synonymous with information sharing. This underlines that counselling guidelines are ambiguous and vague causing confusion between the difference between mandatory information sharing and non-mandatory counselling.