%0 Journal Article
%T How task-sharing in abortion care became the norm in Sweden: A case study of historic and current determinants and events.
%A Endler M
%A Cleeve A
%A Sääv I
%A Gemzell-Danielsson K
%J Int J Gynaecol Obstet
%V 150
%N 0
%D Jul 2020
%M 33219992
%F 4.447
%R 10.1002/ijgo.13003
%X We performed a country case study using thematic analysis of interviews and existing grey and published literature to identify facilitators and barriers to the implementation of midwife-provided abortion care in Sweden. Identified facilitating factors were: (1) the historical role and high status of Swedish midwives; (2) Swedish research and development of medical abortion that enabled an enlarged clinical role for midwives; (3) collaborations between individual clinicians and researchers within the professional associations, and the autonomy of clinical units to implement changes in clinical practice; (4) a historic precedent of changes in abortion policy occurring without prior official or legal sanction; (5) a context of liberal abortion laws, secularity, gender equality, public support for abortion, trust in public institutions; and (6) an increasing global interest in task-shifting to increase access and reduce costs. Identified barriers/risks were: (1) the lack of systems for monitoring and evaluation; and (2) a loss of physician competence in abortion care.