Ethical perspectives of obstetricians and gynecologists on induced abortion and conscientious objection in Türkiye: a phenomenological study

BACKGROUND: Although abortion has been legally permitted in Türkiye for up to ten weeks since 1983, access in public hospitals has been reported to decline over the past decade due to clinicians’ refusals and institutional restrictions, despite the absence of a formal legal framework for conscientious objection. This study aims to explore the experiences and ethical reasoning of Turkish obstetricians and gynecologists regarding abortion practice and conscientious objection, with the goal of illuminating the ethico-legal tensions at play and informing clearer regulatory and institutional guidelines. METHODS: This study employed a qualitative, phenomenological design. Fourteen specialists were recruited via purposive and snowball sampling; semi-structured online interviews were conducted between January–May 2025 using a guide with four interrelated domains. Audio was transcribed verbatim and analyzed in MAXQDA-10. A three-stage, iterative thematic analysis (independent coding, expert consultation, framework refinement) was undertaken until thematic saturation was confirmed. RESULTS: Thematic analysis identified four main themes: (1) legal knowledge and clinical approach to abortion, (2) moral reasoning in abortion decisions, (3) operationalizing conscientious objection in clinical settings, and (4) ethical conflicts between conscience and care. Each of these themes consisted of several subthemes. CONCLUSION: Abortion care in Türkiye is shaped by negotiations between law, morality, and institutional practice. Conscientious objection, though not legally recognized, is nonetheless practiced covertly as a contingent and relational stance, jeopardizing women’s reproductive autonomy. These findings underscore the fragility of reproductive rights and the urgent need for stronger policy frameworks to safeguard access, and autonomy.