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Disrupting systems: Midwives’ experiences with providing abortion care in Canada
1
Karolinska Institute, Department of Women's and Children's Health, Stockholm, Canada
2
Canadian Association of Midwives, National Programs, Montreal, Canada
Eur J Midwifery 2026;10(Supplement 1):A351
ABSTRACT
BACKGROUND:
Midwives in Canada have the skills and knowledge to provide abortion care, yet face systemic barriers to doing so. As health professionals grounded in community-based, culturally safe care, they are uniquely positioned to expand equitable access to abortion services, particularly for underserved populations.
OBJECTIVES:
To explore midwives’ experiences in providing or working toward providing abortion care, with a focus on health system facilitators, barriers, and midwives’ values, needs, and preferences related to implementation.
METHODS:
This exploratory qualitative study involved 25 semi-structured interviews and three focus group discussions with midwives across Canada. Data were analyzed deductively using Braun and Clarke’s reflexive thematic analysis and were shaped by an existing theoretical framework, reproductive justice. This research study received approval by the Community Research Ethics Board, located in Waterloo, Ontario, Canada (Research Project #316). Each participant provided written informed consent.
RESULTS:
Participants reported numerous systemic barriers to abortion care provision, including restrictive regulatory frameworks, inflexible funding mechanisms, and a lack of institutional support. Despite these constraints, midwives described a variety of ways they were providing abortion care in their community and navigating health system barriers. Midwives articulated strong commitments to reproductive justice and identified specific reforms to better integrate abortion care within midwifery practice and health systems in Canada.
CONCLUSIONS:
Midwives are demonstrating leadership in advancing access to abortion care through client-centred, community-rooted approaches. Policy and funding reforms are urgently needed to enable midwives to practice to their full scope and improve access to comprehensive sexual and reproductive healthcare in Canada and globally.
KEY MESSAGE:
Midwives are essential to ensuring equitable abortion access. Removing structural barriers to midwife-led abortion care is a critical step toward achieving reproductive justice. SRHR - Abortion
Midwives in Canada have the skills and knowledge to provide abortion care, yet face systemic barriers to doing so. As health professionals grounded in community-based, culturally safe care, they are uniquely positioned to expand equitable access to abortion services, particularly for underserved populations.
OBJECTIVES:
To explore midwives’ experiences in providing or working toward providing abortion care, with a focus on health system facilitators, barriers, and midwives’ values, needs, and preferences related to implementation.
METHODS:
This exploratory qualitative study involved 25 semi-structured interviews and three focus group discussions with midwives across Canada. Data were analyzed deductively using Braun and Clarke’s reflexive thematic analysis and were shaped by an existing theoretical framework, reproductive justice. This research study received approval by the Community Research Ethics Board, located in Waterloo, Ontario, Canada (Research Project #316). Each participant provided written informed consent.
RESULTS:
Participants reported numerous systemic barriers to abortion care provision, including restrictive regulatory frameworks, inflexible funding mechanisms, and a lack of institutional support. Despite these constraints, midwives described a variety of ways they were providing abortion care in their community and navigating health system barriers. Midwives articulated strong commitments to reproductive justice and identified specific reforms to better integrate abortion care within midwifery practice and health systems in Canada.
CONCLUSIONS:
Midwives are demonstrating leadership in advancing access to abortion care through client-centred, community-rooted approaches. Policy and funding reforms are urgently needed to enable midwives to practice to their full scope and improve access to comprehensive sexual and reproductive healthcare in Canada and globally.
KEY MESSAGE:
Midwives are essential to ensuring equitable abortion access. Removing structural barriers to midwife-led abortion care is a critical step toward achieving reproductive justice. SRHR - Abortion
| eISSN: | 2585-2906 |
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