The role of midwives in first-trimester abortion care: A 40-year experience in Tunisia.

OBJECTIVE

To review the relevant literature on abortion and summarize interviews with key stakeholders to assess the role of midwives in the evolution of abortion-related care in Tunisia.

METHODS

Interviews with eight stakeholders from different organizations based on a guide developed for the study, focusing on policies, strategies used for implementation, capacities used for expansion, user opinions and experience, obstacles and facilitators, and control and evaluation.

RESULTS

Task-sharing for midwifes was encouraged in the family planning program from the beginning and when medical abortion was introduced. It allows midwifes to contribute widely, develop good skills and performance for several tasks, and helps reduce regional disparities in human resource allocation. Success and safety of home use of medical abortion confirms the ability of women to manage their own abortion. Yet, obstacles to accessing abortion still exist for several reasons.

CONCLUSION

This study, based on interviews with personnel with significant experience and solid knowledge of sexual and reproductive health services, allowed us to consider proposals for a future strategy to integrate task-sharing into abortion care and address the barriers to legal and safe abortion access for all women in Tunisia.