Navigating the Minefield: Women's Experiences of Abortion in a Country with a Conscience Clause—The Case of Croatia

Many countries around the world have a conscience clause allowing physicians and health care providers to opt-out of performing abortions. This practice of conscientious objection to abortion care affects both healthcare providers and women's access to abortion care. In Croatia, a conscience clause was introduced in 2003. Nonetheless, women's experiences of abortion after the introduction have not been previously studied. The aim of our study was to explore women's experiences of abortion and conscientious objection in a country with a conscience clause. The study has a qualitative inductive and explorative design. We interviewed seven (7) women in Croatia with experience of an unwanted pregnancy or abortion and analyzed the interviews using thematic content analysis. Our findings revealed one overarching theme: ‘Navigating the minefield—women's experiences of abortion in a country with a conscience clause’ and three categories: ‘Experiencing abortion—to endure a vulnerable situation,’ ‘The conscientious objection in practice—causing obstacles and stigma,’ and ‘Views on abortion—socio-cultural and religious influence’. The women perceived the abortion decision as being difficult and expressed feelings of shame, guilt, and fears of being judged in line with the general attitude toward abortion in society. They described the conscientious objection as having consequences in public healthcare by limiting their access to abortion care and affecting treatment in terms of i.e. derogatory comments, limited or lacking information about the abortion procedure and/or absent contraceptive counseling post abortion. According to the women, a shift towards more conservative ideas towards abortion seem to have taken place in the Croatian society. The conscientious objection was believed to reinforce a moralizing view of sexuality, where the women’s decisions regarding abortion became a collective concern causing stigma and involuntary social alienation. The conscientious clause made the women feel they had to navigate a ‘minefield,’ where their dependency situation and vulnerability in the abortion situation were reinforced by social stigma. 1 Dubravka Ida Gladoić Håkansson is a registered nurse midwife, Master of Science in Sexology, and affiliated to the Centre for Sexology and Sexuality Studies at Malmö University, Sweden. She is authorized specialist in clinical sexology at Nordic Association of Clinical Sexology and authorised supervisor in sexology at Swedish Association for Sexology. Her main research interests are perspectives on abortion, sexuality and reproductive health. 2 Pernilla Ouis is an Associate Professor of Health and Society, in the field of Ethnic Relations, and affiliated to the Centre for Sexology and Sexuality Studies at Malmö University, Sweden. Her main research interest is SRHR (sexual and reproductive health and rights) in traditional contexts, and in relation to migration processes. She is recently appointed Professor in Social Work at Halmstad University, Sweden. 3 Maria Ekstrand Ragnar is a registered nurse midwife, lecturer at the Department of Health Sciences at the Faculty of Medicine, Lund University and affiliated researcher at the Department of Women’s and Children’s Health at Uppsala University, Sweden. Her main interests within midwifery research are perspectives on abortion, sexual risk taking and sexual and reproductive health.