title: Equitable abortion care - A challenge for health care providers. Experiences from abortion care encounters with immigrant women in Stockholm, Sweden.
abstract: OBJECTIVE
  To explore health care providers' experiences of providing care to immigrant women seeking abortion care.
  
  
  METHODS
  A qualitative study including interviews with ten midwives and three medical doctors at four abortion clinics in the Stockholm area. Interviews were analysed using thematic analysis.
  
  
  RESULTS
  Initially, health care providers were reluctant to make statements concerning the specific needs among immigrant women. Yet, the health care providers sometimes found it challenging to deal with the specific needs among immigrant, mostly non-European, women. Three themes were identified: (1) Reluctance to acknowledge specific needs among immigrant women; (2) Striving to provide contraceptive counselling to immigrant women; (3) Organizational barriers hindering patient-centred abortion care to immigrant women CONCLUSIONS: Health care providers' experiences of the specific needs among non-European, immigrant women are not openly discussed, although they are acknowledged. To achieve equitable access to sexual and reproductive health (SRH), health care providers need to be better equipped when encountering immigrant women in abortion care, especially regarding contraceptive counselling. The potential impact of patients' knowledge, norms and values is not adequately dealt with in the clinical encounter. Moreover, to provide patient-centred care, it is crucial to understand how to develop and implement SRH care that ensures equal access to high-quality care.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Women's and Children's Health/IMCH, Uppsala University, Uppsala, Sweden. Electronic address: elin.larsson@ki.se.
authors.forename: Elin C
authors.initials: EC
authors.lastname: Larsson
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fried
authors.affiliation: Department of Women's and Children's Health/IMCH, Uppsala University, Uppsala, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Essén
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Klingberg-Allvin
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology; D003144:Communication Barriers; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D009313:National Health Programs; D036301:Qualitative Research; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D013548:Sweden
keywords: Equity in care; Immigrant; Induced abortion; Patient-centred care; Qualitative method; Sexual and reproductive health