How Are Healthcare Providers Conscientiously Objecting to Abortion in Australia? A Qualitative Study

INTRODUCTION: Researchers have done limited empirical work to explore how healthcare providers are claiming conscientious objection to abortion care in Australia. Without this research, we cannot assess if existing mechanisms to regulate conscientious objection meet the needs of abortion seekers, abortion providers, and healthcare providers who conscientiously object to abortion care. METHODOLOGY: We conducted semi-structured interviews with 41 interest-holders (including healthcare providers who provided or conscientiously objected to abortion care) across Australia about conscientious objection to abortion care and its regulation. We analyzed the data using framework analysis. RESULTS: We identified four themes describing how healthcare providers were claiming conscientious objection to abortion care. First, claims existed on a spectrum from "partial provision" to "refusal without referral." When healthcare providers refused to provide an abortion, they did not always refer the abortion seeker to a willing provider or service. Second, claims of conscientious objection could change over time. Third, the relationship between religion and conscientious objection was not necessarily direct. Finally, some healthcare providers refused to provide abortion for reasons other than conscience. CONCLUSION: The findings demonstrated that conscientious objection provisions provided a flexible mechanism for healthcare providers to opt-out of providing abortion care at different times, in different contexts, and for different reasons (including reasons other than conscience). Education and guidelines may improve healthcare providers' understandings and interpretations of conscientious objection provisions. Destigmatizing interventions may also reduce the number of healthcare providers who refuse to participate in abortion care for conscience-based and non-conscience-based reasons.