ABOUT THE PROVIDERS SHARE WORKSHOP

The Providers Share Workshop: Background and history

Our team developed the Providers Share Workshop, a facilitated group workshop, to help alleviate some of the unique burdens of providing abortion care, in particular the burden of stigma. We developed it based on the observation that those who provide abortion care often work in relative isolation and frequently do not talk about their work, even with each other. Furthermore, there were no supportive interventions available at the time. We designed PSW to: provide caregivers who do abortion work with a space for discussing experiences about which they had previously remained silent, help better understand the experiences of abortion providers, and strengthen human resources for abortion care. It began as a pilot study at one abortion care facility in the United States in 2007. To date, well over 1,000 abortion caregivers from North America, South America, Africa and Asia have participated.

The Providers Share Workshop model

The Providers Share Workshop is a 5-session group workshop, led by an experienced facilitator trained by our team. The typical workshop model covers five workshop sessions over two consecutive days. All sessions are designed to address important aspects of people's experiences of working in abortion care, particularly experiences of stigma, and to support caregivers in maintaining a resilient and high-functioning clinic team. The Workshop employs arts-based methods that are known to facilitate communication about sensitive subjects and to increase confidence among participants. The PSW sessions are:

• “What helping women end their pregnancies means to me” – Participants share their experiences as abortion care providers using personal and symbolic items.
• “What helping women end their pregnancies means to my community” – A PhotoVoice activity where participants share a photograph that represents what abortion work means to their community.
• “Managing stigma: The decision to disclose” – Participants share if, when, how and to whom they disclose their work in abortion care.
• “Memorable cases and difficult complications” – Participants share abortion care stories of particular significance to them.
• “Imagining a world without abortion stigma” – Participants create Paper Prayers (similar to a collage) to explore their commitments to creating a future without abortion stigma.

Workshop findings

The Providers Share Workshop serves simultaneously as an intervention and a research opportunity. We have collected quantitative and/or qualitative data in all workshop iterations, and have learned a lot about provider’s experiences at the same time that we have helped support them. In early workshops, we realized we were indeed hearing about the phenomenon of stigma. While very few participants at that time used the term “stigma”, they all described the marginalization, stereotyping and devaluation that define it. Participants routinely encountered stigma in a range of sites, including in public discourse and media coverage, in institutions such as other hospitals, in community settings such as schools and churches, among their family and friends and as well as internalized stigma within themselves.

Following the pilot study, we realized that stigma is a phenomenon that can be quantified. We developed the Abortion Provider Stigma Scale to capture providers experiences of and responses to abortion stigma. We learned that providers do feel devalued and have difficulty disclosing their work to others, and that they derive high levels of pride from their work, which may potentially insulate them from the negative impacts of abortion stigma. We also found in our quantitative analysis that stigma is the best predictor of professional burnout - that is, the more stigmatized one feels, the more burnt out they feel from their jobs.

In studies of the Providers Share Workshop in the U.S., Latin America, Africa and Asia, we have observed statistically significant improvements in experiences of stigma in virtually all regions. Experiences of professional burnout also improved. We observed numerous other favorable changes, including more favorable attitudes toward women seeking abortion and increased willingness to engage in legal advocacy.

Additionally, in virtually all study sites, we received an overwhelmingly positive response and high regard for the workshop. Nearly all participants report that the workshop helped them explore topics they don’t normally talk about in their work, re-affirmed their commitment to the work, and was an experience they would recommend to others.