Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101691
Waltraud Maierhofer
Director: Anne Zohra Berrached. Authors (screenplay): Carl Gerber, Anne Zohra Berrached. Germany, 2016. 103 minutes. UK film release: January 2017. UK DVD release: March 2017 “Women's rights are human rights, and human rights are women's rights”, Hillary Clinton told the United Nations Fourth World Conference on Women (Beijing, September 1995). Yet 20 years later she was accused of being a murderer for speaking in favour of legal late-term abortion in her presidential campaign. Her response was nuanced and expressed compassion for women facing the medical realities that drive a late-term abortion. It is a decision that is all too often glossed over or portrayed with tired stereotypes in modern media. The German film, 24 Weeks, innovatively and convincingly shows the difficulties of such a decision: bombardment with advice, data, and opinions from all directions, the rollercoaster of emotions, and the unforeseeable impact on even the happiest couple and family. It avoids simplistic moralism and focuses on the decision at hand. 24 Weeks premiered at the 2016 Berlinale film festival to much critical acclaim and has since won several awards. One of the film's strengths is the exquisite performances. Astrid (Julia Jentsch) and Markus (Bjarne Madel) are a well-off, happy and loving couple and parents of a …
{"title":"24 Weeks (24 Wochen)","authors":"Waltraud Maierhofer","doi":"10.1136/jfprhc-2016-101691","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101691","url":null,"abstract":"Director: Anne Zohra Berrached. Authors (screenplay): Carl Gerber, Anne Zohra Berrached. Germany, 2016. 103 minutes. UK film release: January 2017. UK DVD release: March 2017\u0000\u0000“Women's rights are human rights, and human rights are women's rights”, Hillary Clinton told the United Nations Fourth World Conference on Women (Beijing, September 1995). Yet 20 years later she was accused of being a murderer for speaking in favour of legal late-term abortion in her presidential campaign. Her response was nuanced and expressed compassion for women facing the medical realities that drive a late-term abortion. It is a decision that is all too often glossed over or portrayed with tired stereotypes in modern media.\u0000\u0000The German film, 24 Weeks, innovatively and convincingly shows the difficulties of such a decision: bombardment with advice, data, and opinions from all directions, the rollercoaster of emotions, and the unforeseeable impact on even the happiest couple and family. It avoids simplistic moralism and focuses on the decision at hand. 24 Weeks premiered at the 2016 Berlinale film festival to much critical acclaim and has since won several awards.\u0000\u0000One of the film's strengths is the exquisite performances. Astrid (Julia Jentsch) and Markus (Bjarne Madel) are a well-off, happy and loving couple and parents of a …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"82 - 83"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101691","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101659
A. Berger
“Am I pregnant?” she asked nervously. Of course I had no idea but it seemed unlikely from her history. She was determined not to take a test and just wanted me to say “no”. I couldn't. “Well maybe it's just my hormones?” she asked again, hopefully. I could give her no certainty about that either. She is a 32-year-old full-time city worker holding down an intensely demanding job. She looked exhausted and exuded nervous energy. There was plenty of life stuff that might be causing her erratic periods and tiredness, but nothing she wanted to examine, as long as I was sure she couldn't blame her hormones. Next up was a 23-year-old sedentary secretary with mild facial acne and a degree of obesity. She was sure she had …
{"title":"Learning with patience","authors":"A. Berger","doi":"10.1136/jfprhc-2016-101659","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101659","url":null,"abstract":"“Am I pregnant?” she asked nervously. Of course I had no idea but it seemed unlikely from her history. She was determined not to take a test and just wanted me to say “no”. I couldn't. “Well maybe it's just my hormones?” she asked again, hopefully. I could give her no certainty about that either. She is a 32-year-old full-time city worker holding down an intensely demanding job. She looked exhausted and exuded nervous energy. There was plenty of life stuff that might be causing her erratic periods and tiredness, but nothing she wanted to examine, as long as I was sure she couldn't blame her hormones.\u0000\u0000Next up was a 23-year-old sedentary secretary with mild facial acne and a degree of obesity. She was sure she had …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"76 - 76"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101580
J. Lord
The authors of the article ‘Identifying indicators for quality abortion care: a systematic literature review’ in this journal issue1 deserve admiration for having proposed an academic solution to address the paucity of work in this area. It is telling that only 21 relevant publications could be identified in the literature, despite abortion being such a common health need that a significant proportion of the population will access. In other areas of medicine the quality agenda has become mainstream. In contrast, those involved in abortion care frequently work in isolation and have had to concentrate on operating in difficult legal and social environments where defined quality indicators could be used against them further to restrict access. It is therefore heartening to see this article published …
{"title":"Quality and abortion services","authors":"J. Lord","doi":"10.1136/jfprhc-2016-101580","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101580","url":null,"abstract":"The authors of the article ‘Identifying indicators for quality abortion care: a systematic literature review’ in this journal issue1 deserve admiration for having proposed an academic solution to address the paucity of work in this area. It is telling that only 21 relevant publications could be identified in the literature, despite abortion being such a common health need that a significant proportion of the population will access. In other areas of medicine the quality agenda has become mainstream. In contrast, those involved in abortion care frequently work in isolation and have had to concentrate on operating in difficult legal and social environments where defined quality indicators could be used against them further to restrict access. It is therefore heartening to see this article published …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"16 - 17"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63793866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2015-101383
A. Erfani
Objective In response to a persistent low fertility rate in the country, the Supreme Leader of Iran in 2012 called for the shift to pronatalist population policies. Consequently, Iran's Parliament proposed a bill to curb the provision of contraceptive knowledge and services as a solution to raising the country's low fertility rate. This study aimed to investigate which groups of women will be adversely affected if the provision of subsidised contraceptive methods [i.e. sterilisation, intrauterine device (IUD) and injections] is curbed. Methods This study used recent data from the 2014 Tehran Survey of Fertility (n=3012) conducted among a representative sample of 3012 married women of reproductive age, and used multinomial logistic regression analysis to identify women with a higher likelihood of using government-funded contraceptive methods. Results Currently 82% of married women living in Tehran use a contraceptive method. The use of long-acting contraception, namely sterilisation and IUDs, declined from 34% in 2000 to 20% in 2014, and the prevalence of male methods (withdrawal and condoms) increased from 33% to 55% in the same period. Multivariate results showed that women who have a large number of children, want no more children, live in poor districts, and have low education are more likely to use long-acting contraceptive methods than withdrawal and condoms. Conclusions Women of low socioeconomic status who want to stop childbearing are the most vulnerable subgroups of the population if the publicly-funded family planning services are curbed.
{"title":"Curbing publicly-funded family planning services in Iran: who is affected?","authors":"A. Erfani","doi":"10.1136/jfprhc-2015-101383","DOIUrl":"https://doi.org/10.1136/jfprhc-2015-101383","url":null,"abstract":"Objective In response to a persistent low fertility rate in the country, the Supreme Leader of Iran in 2012 called for the shift to pronatalist population policies. Consequently, Iran's Parliament proposed a bill to curb the provision of contraceptive knowledge and services as a solution to raising the country's low fertility rate. This study aimed to investigate which groups of women will be adversely affected if the provision of subsidised contraceptive methods [i.e. sterilisation, intrauterine device (IUD) and injections] is curbed. Methods This study used recent data from the 2014 Tehran Survey of Fertility (n=3012) conducted among a representative sample of 3012 married women of reproductive age, and used multinomial logistic regression analysis to identify women with a higher likelihood of using government-funded contraceptive methods. Results Currently 82% of married women living in Tehran use a contraceptive method. The use of long-acting contraception, namely sterilisation and IUDs, declined from 34% in 2000 to 20% in 2014, and the prevalence of male methods (withdrawal and condoms) increased from 33% to 55% in the same period. Multivariate results showed that women who have a large number of children, want no more children, live in poor districts, and have low education are more likely to use long-acting contraceptive methods than withdrawal and condoms. Conclusions Women of low socioeconomic status who want to stop childbearing are the most vulnerable subgroups of the population if the publicly-funded family planning services are curbed.","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"37 - 43"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2015-101383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63793517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101614
R. Duthie
{"title":"Girl Up","authors":"R. Duthie","doi":"10.1136/jfprhc-2016-101614","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101614","url":null,"abstract":"","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"84 - 84"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101679
L. Edouard
In this journal issue, Erfani provides new data addressing likely effects of the current pronatalist policy in Iran. Using data from the 2014 Tehran Survey of Fertility, this international study estimates the likely impact of policy change on future fertility and service delivery. It is a study that exemplifies the value of collaboration between countries which share values on good governance relating to the right to health. Drawing on funding and research resources in both Iran and Canada, which is home to a significant Iranian diaspora, this study anticipates major effects from the reduction of free contraceptive services on both demographic indicators at the population level and quality of care at the individual level.1 These changes can best be appreciated against the background of Iran's excellent track record in providing contraceptive services. Family planning received international recognition in 1978 when it was included as a component of maternal and child health, and incorporated …
{"title":"Contraception in Iran: revolution and evolution","authors":"L. Edouard","doi":"10.1136/jfprhc-2016-101679","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101679","url":null,"abstract":"In this journal issue, Erfani provides new data addressing likely effects of the current pronatalist policy in Iran. Using data from the 2014 Tehran Survey of Fertility, this international study estimates the likely impact of policy change on future fertility and service delivery. It is a study that exemplifies the value of collaboration between countries which share values on good governance relating to the right to health. Drawing on funding and research resources in both Iran and Canada, which is home to a significant Iranian diaspora, this study anticipates major effects from the reduction of free contraceptive services on both demographic indicators at the population level and quality of care at the individual level.1 These changes can best be appreciated against the background of Iran's excellent track record in providing contraceptive services.\u0000\u0000Family planning received international recognition in 1978 when it was included as a component of maternal and child health, and incorporated …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"5 - 6"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-13DOI: 10.1136/jfprhc-2016-101637
R. Beerthuizen
A prospective study in this journal issue compares the effects on maternal bone turnover during lactation of subdermal implant compared with copper intrauterine device (IUD) use.1 It is interesting because publications about the influence of hormonal contraceptives on the health of the lactating woman herself are rare. This study’s advantage is that bone mineral density mostly is measured using dual-energy X-ray absorptiometry or a similar modality, rather than relying on biochemical analyses of serum and urine samples.1 Its …
{"title":"Safety and efficacy of the subdermal etonogestrel contraceptive implant Implanon®","authors":"R. Beerthuizen","doi":"10.1136/jfprhc-2016-101637","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101637","url":null,"abstract":"A prospective study in this journal issue compares the effects on maternal bone turnover during lactation of subdermal implant compared with copper intrauterine device (IUD) use.1 It is interesting because publications about the influence of hormonal contraceptives on the health of the lactating woman herself are rare. This study’s advantage is that bone mineral density mostly is measured using dual-energy X-ray absorptiometry or a similar modality, rather than relying on biochemical analyses of serum and urine samples.1 Its …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"118 - 118"},"PeriodicalIF":0.0,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-09DOI: 10.1136/jfprhc-2016-101605
S. Thapa, G. Acharya
Nepal was hit by a powerful earthquake in 2015, causing enormous damage to physical infrastructure and human lives in many parts of the country. It caused serious threat to women's and children’s health both during and after the earthquake. An article in this issue of the journal highlights one easily forgotten hardship among many faced by women in this situation. Budhathoki and coworkers describe the difficulties surrounding menstrual hygiene in post-earthquake Nepal, where women used and reused clothes as sanitary towels – a practice that was considered culturally acceptable and feasible in crisis situations.1 The authors argue that menstrual hygiene received a low priority due to the overwhelming need of water, food and shelter in such crisis situations. An earlier report based on field visits carried out in temporary camps in Sindhupalchok district has also highlighted that menstruation and childbirth are considered natural physiological phenomena not requiring attention, and are not prioritised in disaster areas.2 Even before the earthquake, women's health had not been prioritised in Nepal, …
{"title":"Women's health is not in focus in disaster zones: lessons from the Nepal earthquake","authors":"S. Thapa, G. Acharya","doi":"10.1136/jfprhc-2016-101605","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101605","url":null,"abstract":"Nepal was hit by a powerful earthquake in 2015, causing enormous damage to physical infrastructure and human lives in many parts of the country. It caused serious threat to women's and children’s health both during and after the earthquake. An article in this issue of the journal highlights one easily forgotten hardship among many faced by women in this situation. Budhathoki and coworkers describe the difficulties surrounding menstrual hygiene in post-earthquake Nepal, where women used and reused clothes as sanitary towels – a practice that was considered culturally acceptable and feasible in crisis situations.1 The authors argue that menstrual hygiene received a low priority due to the overwhelming need of water, food and shelter in such crisis situations. An earlier report based on field visits carried out in temporary camps in Sindhupalchok district has also highlighted that menstruation and childbirth are considered natural physiological phenomena not requiring attention, and are not prioritised in disaster areas.2\u0000\u0000Even before the earthquake, women's health had not been prioritised in Nepal, …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"92 - 93"},"PeriodicalIF":0.0,"publicationDate":"2016-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-09DOI: 10.1136/jfprhc-2016-101606
Jessica H Zafra-Tanaka, Nicolaz Merino-Garcia, Alvaro Taype-Rondan
Each year, approximately 20 million unsafe abortions – those performed by people lacking necessary skills or in environments lacking minimal medical standards, or both – take place worldwide, producing a variety of complications such as incomplete abortion, haemorrhage, sepsis, peritonitis, cervical, vaginal or uterine trauma, psychological problems, chronic infection, infertility, and death.1 Moreover, in countries where abortion is penalised, the incidence of unsafe abortions is 23 per 1000 women of childbearing age (WCA), considerably higher than the 2 per 1000 WCA observed in countries where abortion is not penalised.1 In Peru, abortion is illegal, except when it is the only option to prevent death or permanent health damage to the woman. In such cases, abortion is regulated by a technical guideline approved in 2014, which aims to improve access to this procedure, although it is not being broadly used by Peruvian doctors …
{"title":"Poverty and abortion complications in Peru","authors":"Jessica H Zafra-Tanaka, Nicolaz Merino-Garcia, Alvaro Taype-Rondan","doi":"10.1136/jfprhc-2016-101606","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101606","url":null,"abstract":"Each year, approximately 20 million unsafe abortions – those performed by people lacking necessary skills or in environments lacking minimal medical standards, or both – take place worldwide, producing a variety of complications such as incomplete abortion, haemorrhage, sepsis, peritonitis, cervical, vaginal or uterine trauma, psychological problems, chronic infection, infertility, and death.1 Moreover, in countries where abortion is penalised, the incidence of unsafe abortions is 23 per 1000 women of childbearing age (WCA), considerably higher than the 2 per 1000 WCA observed in countries where abortion is not penalised.1 \u0000\u0000In Peru, abortion is illegal, except when it is the only option to prevent death or permanent health damage to the woman. In such cases, abortion is regulated by a technical guideline approved in 2014, which aims to improve access to this procedure, although it is not being broadly used by Peruvian doctors …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"80 - 81"},"PeriodicalIF":0.0,"publicationDate":"2016-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101606","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-02DOI: 10.1136/jfprhc-2016-101541
L. Keogh, D. Newton, C. Bayly, K. McNamee, Ann-Marie Hardiman, A. Webster, M. Bismark
Introduction In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform. Methods Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached. Nineteen experts from a range of health care settings and geographic locations were interviewed in 2014/2015. Thematic analysis was conducted to summarise participants' views. Results Abortion law reform, while a positive event, was perceived to have changed little about the provision of abortion. The views of participants can be categorised into: (1) goals that law reform was intended to address and that have been achieved; (2) intent or hopes of law reform that have not been achieved; (3) unintended consequences; (4) coincidences; and (5) unfinished business. All agreed that law reform had repositioned abortion as a health rather than legal issue, had shifted the power in decision making from doctors to women, and had increased clarity and safety for doctors. However, all described outstanding concerns; limited public provision of surgical abortion; reduced access to abortion after 20 weeks; ongoing stigma; lack of a state-wide strategy for equitable abortion provision; and an unsustainable workforce. Conclusion Law reform, while positive, has failed to address a number of significant issues in abortion service provision, and may have even resulted in a ‘lull’ in action.
{"title":"Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia","authors":"L. Keogh, D. Newton, C. Bayly, K. McNamee, Ann-Marie Hardiman, A. Webster, M. Bismark","doi":"10.1136/jfprhc-2016-101541","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101541","url":null,"abstract":"Introduction In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform. Methods Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached. Nineteen experts from a range of health care settings and geographic locations were interviewed in 2014/2015. Thematic analysis was conducted to summarise participants' views. Results Abortion law reform, while a positive event, was perceived to have changed little about the provision of abortion. The views of participants can be categorised into: (1) goals that law reform was intended to address and that have been achieved; (2) intent or hopes of law reform that have not been achieved; (3) unintended consequences; (4) coincidences; and (5) unfinished business. All agreed that law reform had repositioned abortion as a health rather than legal issue, had shifted the power in decision making from doctors to women, and had increased clarity and safety for doctors. However, all described outstanding concerns; limited public provision of surgical abortion; reduced access to abortion after 20 weeks; ongoing stigma; lack of a state-wide strategy for equitable abortion provision; and an unsustainable workforce. Conclusion Law reform, while positive, has failed to address a number of significant issues in abortion service provision, and may have even resulted in a ‘lull’ in action.","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"117 1","pages":"18 - 24"},"PeriodicalIF":0.0,"publicationDate":"2016-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63793809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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