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\title{Accessing termination of pregnancy due to fetal anomaly during COVID-19
in South Australia: A qualitative case study}



\author[1]{Amy Watson}%
\author[1]{Brigid Coombe}%
\author[2]{Ivanka Prichard}%
\author[1]{Ea Mulligan}%
\author[2]{Jessica Shipman}%
\affil[1]{Flinders University}%
\affil[2]{Flinders University Caring Futures Institute}%


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  \date{May 07, 2026}


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\begin{abstract}
Objective Examine experiences of termination of pregnancy (TOP) in South
Australia to recommend areas for service improvement following
decriminalisation legislation. Design Qualitative case study. Setting
Online semi-structured interview. Participants The case study was an
example of the unheard, complex and distressing circumstance of TOP due
to fetal anomaly diagnosis. The case was selected from larger sample
(N=8) of adults who had recently had a TOP in South Australia as a
subgroup from a larger study looking at the potential missed
opportunities of health professionals to provide access to contraception
prior to abortion. Methods Semi-structured, in depth, qualitative
interview. Qualitative description using thematic content analysis
identified significant aspects of the participant's story pertaining to
potential health service improvements. Results The participant
experienced trauma navigating a difficult care pathway following a
diagnosis of fetal anomaly. They described inadequacy of labels for
pregnancy such as planned, unplanned, wanted, unwanted, the framing of
abortion through the lens of `choice', and confusion about service
referrals and inappropriate communication by health professionals. Not
being able to have a partner accompany her through the process of having
a TOP due to COVID-19 restrictions resulted in extreme distress.
Conclusion Abortion services need clear care pathways that are context
specific, and patient centred. The language and attitudes of health
professionals can result in distressing experiences of TOP. Further
investigation of the relationship between infection control strategies
and trauma in health service provision is warranted to improve future
pandemic responses.%
\end{abstract}%



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