Insights: Values Clarification for Abortion
Written by Judy Lipshutz, MSW, RN
Values Clarification (VC) is a process of self-reflection that encourages honest and respectful conversations about how our values impact the care we provide. We all have values, opinions, biases, and identities; and we come from different generations, cultures, races, and religions. Developing self-awareness about how our values impact our work better positions us to provide non-judgmental care and helps to address abortion stigma. “The World Health Organization recommends values clarification training for abortion providers to address the role that abortion stigma plays in preventing people from getting the care they need.”1
Research has shown how VC training can create change. In 2018 and 2019, researchers provided a VC workshop to OB/GYN residents at five Catholic residency programs that did not provide abortion training. The authors found “a change in attitudes related to acceptability and morality about abortion scenarios that may lead to unmeasured reductions in abortion stigma that may consciously or unconsciously have a negative impact on patients/clients.”2
Understanding and addressing staff members’ concerns about providing abortion care is an important part of integrating abortion care into health center services. VC can be powerful for helping staff to understand how their own values, feelings, and attitudes impact patient care. And, staff at all levels (clinical, non-clinical, and front desk staff) should be part of the process because a patient’s health care experience starts at the health center’s front door.
Effective VC facilitation requires strong skills (e.g., objectivity, empathy, self-reflection, and conflict resolution). Facilitators should encourage dialogue about sensitive issues, and promote a sense of safety and community. One way of achieving this is to explain the activity well, and develop group norms with participants. For example:
“Participants in this workshop will be discussing sensitive, challenging issues and they need a non-judgmental, brave, safe-to-fail environment, so let’s spend a few minutes talking about some norms.”
Facilitators will also need to develop comfort with redirection strategies to address tension and center respect (e.g., acknowledging feelings, re-visiting group norms, taking breaks, opening up the conversation to the group, and steering participants to move on). For example, imagine during a VC activity a participant discloses their discomfort with being part of providing abortion care to adolescents. They ask the facilitator, why should they be expected to do this? In response, the facilitator can tactfully and respectfully respond by acknowledging the participants’ feelings in thinking about doing something new, and ask the group what they think. This redirection can help to promote discussion about minors’ rights, while acknowledging the person’s discomfort with these feelings. It also helps gauge whether this is an issue for others in the group as well.
VC Activities should be carefully selected based on the group size, time available, and relevance to the culture of the health center. There are many different types of VC activities to choose from including group discussions, agree/disagree activities, case studies, myth/fact exercises, games, role-plays, journaling, and self-reflection. See RHAP’s Values Clarification Activities Guide below, a compilation of specific VC activity descriptions, objectives, facilitator tips, materials needed, and handouts. For more information contact us at program@reproductiveaccess.org
A Final Note: VC calls upon us to dig deeply to consider why someone might feel a certain way, and challenges us to understand the perspectives of others even if we don’t agree. VC is not a “one-off” activity or magic bullet. Instead, VC is a life-long process of self-reflection that can help us to be more empathetic, better understand the lived experiences of our patients, and help to reduce abortion stigma.
RHAP Resources:
Partner Resources:
Abortion attitude transformation: A values clarification toolkit for global audiences
Sources:
Pharma-free: The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Insights is unbiased, based on science alone.
Sign-up to Receive Insights Monthly!
If you enjoyed this Insights, sign up to have them delivered to your inbox! Insights are released on the fourth Tuesday of every month!
Sign-up to Receive Contraceptive Pearls Monthly!
If you enjoyed this Insights article, then check out our Contraceptive Pearls! Contraceptive Pearls are monthly highlights focusing on best practices in patient-centered, evidence-based contraceptive care. Read our latest Pearl here. You can sign up to have Contraceptive Pearls delivered to your inbox! Contraceptive Pearls are released on the third Tuesday of every month!
