2010-06-14 10:30

Focusing on Fertility, Responsibility and Relations

Chance led Britt-Marie Halldén into nursing, and there she has stayed since then. Recently, she defended her doctoral dissertation about teenage abortions, a subject of importance for teenagers as well as midwives and parents.

The dissertation “On Fertility, Responsibility and Relations; a Study of Teenagers’ Experiences of Abortion Early During Pregnancy and Midwifes’ Experiences of Caring in Such Situations” has been given a lot of attention in local media since the nailing to the birches at the University of Borås in March.

“I find it important to spread the results I have found through my research,” says Britt Marie Halldén and talks about how she therefore plans to write about her dissertation in a popular science book. She wants to do this in order to increase access to her results and give young people a chance to understand them. But she is going to wait, first she is taking a breather and contemplating the almost seven years she has spent on her dissertation.

“Abortion is a tough subject to write about and is often ridden with taboos.”

Genuine Experience

Britt-Marie Halldén, born in the village of Dalstorp outside Ulricehamn, graduated as a midwife at the early age of 22. Before that she had had time to educate herself and work as a nurse for a brief period.

“It was by pure coincidence that I got into nursing to begin with, and when I started gaining experience of what working as a nurse meant, I realized that it wasn’t the right thing for me. I needed something more positive, being a nurse means meeting a lot of terminally ill people and I wasn’t up for that.”

“Turning to midwifery was natural, as pregnancy and childbirth are associated with health. Being present at a delivery is a very positive thing. A midwife also focuses a lot on preparations for childbirth in an anticipatory way.”

Apart from working as a midwife Britt-Marie Halldén has also worked as a district nurse. But at the beginning of the 1980’s she shifted focus. The rector for the nursing education in Borås asked her to help out in midwifery, where there was a shortage of teachers.

“After having worked as a nurse and district nurse for ten years I felt I had experience to share. And I stayed in the field!”

Nowadays Britt-Marie Halldén is a university subject teacher at the School of Health Sciences, but she kept one foot in the clinical sphere for a long time.

“Yes, for many years I worked as a midwife at during the summers. It is healthy to dust off your knowledge now and then.”

A Moral Dilemma

As a teacher at the midwife education at the University of Borås, Britt-Marie Halldén discovered that the students are not always aware that being in their profession means meeting women, sometimes very young women, about to have abortions.”

“That has led to a lot of crises for students, it turns into a moral dilemma. I felt that we needed to increase understanding and find out more about how young people reason when they decide to carry out abortions, and how they feel afterwards,” says Britt-Marie Halldén and tells us that abortion is the most common gynecological operation.

“Statistically, every woman has had an abortion in her fertile life. There is however a group of women who have several, which affects the statistics.”

Limited Knowledge in Previous Research

Research about young people’s approach to and feelings about abortions has hitherto been modest. General research about abortions has increased over the past ten years, but a lot is focused on adult women and their abortions.

“I started my research at the beginning of 2003, and it has been a privilege to be able to research half of my time, and teach the other half. In the study I have chosen to focus on people below the age of 20, women as well as their boyfriends,” says Britt-Marie Halldén. She has interviewed ten girls who made the decision to have abortions, ten who had their abortions, ten young men whose girlfriends had abortions and ten midwifes working with teenagers who decide to have abortions.

Her research aims to increase understanding of why teenagers make the choice to go through with abortions. Britt-Marie Halldén concludes that this is also important in preventing teenagers from ending up in that situation to begin with.

“In order to achieve better insight I chose to use an interview technique where I started the interview having prepared only one question, which enabled me to delve deeper into each person’s experiences. It was about achieving a general understanding.”

“The most important discovery in the thesis was how the interplay between those involved was shaped. It is a matter of how people act toward one another, not whether abortion is right or wrong.”

“A large part of the time, girls, or women, just want to be understood. Men also want to participate and support the girls, but they feel pushed away by the nursing staff. In general though, the girls are very lonely in the process, few men make them company.”

“Parents are also a part of the process, many young women are afraid to tell their parents about the abortion. They are afraid of being guilted, not for the abortion itself, but for not having behaved responsibly. Ambiguity often surrounds abortions. What is the essence of the relief that many feel after having gone through with an abortion? And what does the guilt stand for?”

“My study has confirmed the feelings that have been described in previous quantitative studies. But it has also provided an understanding of how to handle those emotions.”

Risk Behaviour Leads to Abortion

There are also indications that among those going through with abortions, there is a group of young people who exhibit risk behaviour and are testing their fertility.

“They do not believe they can get pregnant, and try to get affirmation that they can.”

Britt-Marie Halldén tells us how midwifes experience ambiguity when teenagers use abortion as a late contraceptive.

“Some girls don’t approve of the side effects of modern birth control. Despite the small amount of hormones in the modern pill, it may induce weight gain, acne and so on.”

“Midwifes try to inform and help the girls, but they need more resources and time with each person in order to have time to discuss what they are thinking. In the present situation it is hard to do follow-ups with the teenagers, and find out why, for example, they don’t use the pill.”

The first part of Britt-Marie Halldén’s dissertation sheds light on the complex situation that an abortion constitutes.

“Fertility is central. The joy of being fertile, despite having an abortion. Responsibility is about responsibility towards one another, what to do and what not to do. Relationships are about the relationship between the man and woman, but also the relationship to the fetus, about which both the man and woman have thoughts. Relationships are also about the woman, the man and the midwife talking about people who make a difference in the abortion situation, for example parents, friends and people at school.

Plans for the Future

Apart from the book on popular science that Britt-Marie Halldén is thinking about writing, she is interested in doing further research in the field of abortion.

“There is an interesting problem area surrounding the group of girls who go through with repeated abortions.”

But first she is looking forward to a summer that she will hopefully get to dedicate to her favorite pastimes; long walks in the outdoors with her daughter’s dog and sailing in Bohuslän. Her mission as a lay assessor on the court of appeals will probably take up some of her time too.

Text: Johanna Adamsson
Photo: Jennifer Tydén

Name: Britt-Marie Halldén
On the table: Because of her recent dissertation “On Fertility, Responsibility and Relations; a Study of Teenagers’ Experiences of Abortion Early During Pregnancy and Midwifes’ Experiences of Caring in Such Situations”
Age: Too old…
Family: A daughter and two sons
Lives in: Borås
Prefers doing: Thinks it is nice to be outdoors and likes sailing


Text: Johanna Adamsson
Foto: Jennifer Tydén