Abstract

ObjectiveThe purpose of this study is to explore Protestant religious leaders’ attitudes towards abortion and their strategies for pastoral care in Georgia, USA. Religious leaders may play an important role in providing sexual and reproductive health pastoral care given a long history of supporting healing and health promotion.MethodsWe conducted 20 in-depth interviews with Mainline and Black Protestant religious leaders on their attitudes toward abortion and how they provide pastoral care for abortion. The study was conducted in a county with relatively higher rates of abortion, lower access to sexual and reproductive health services, higher religiosity, and greater denominational diversity compared to other counties in the state. Interviews were audio-recorded, transcribed verbatim, and analyzed by thematic analysis.ResultsReligious leaders’ attitudes towards abortion fell on a spectrum from “pro-life” to “pro-choice”. However, most participants expressed attitudes in the middle of this spectrum and described more nuanced, complex, and sometimes contradictory views. Differences in abortion attitudes stemmed from varying beliefs on when life begins and circumstances in which abortion may be morally acceptable. Religious leaders described their pastoral care on abortion as “journeying with” congregants by advising them to make well-informed decisions irrespective of the religious leader’s own attitudes. However, many religious leaders described a lack of preparation and training to have these conversations. Leaders emphasized not condoning abortion, yet being willing to emotionally support women because spiritual leaders are compelled to love and provide pastoral care. Paradoxically, all leaders emphasized the importance of empathy and compassion for people who have unplanned pregnancies, yet only leaders whose attitudes were “pro-choice” or in the middle of the spectrum expressed an obligation to confront stigmatizing attitudes and behaviors towards people who experience abortion. Additionally, many leaders offer misinformation about abortion when offering pastoral care.ConclusionThese findings contribute to limited empirical evidence on pastoral care for abortion. We found religious leaders hold diverse attitudes and beliefs about abortion, rooted in Christian scripture and doctrine that inform advice and recommendations to congregants. While religious leaders may have formal training on pastoral care in general or theological education on the ethical issues related to abortion, they struggle to integrate their knowledge and training across these two areas. Still, leaders could be potentially important resources for empathy, compassion, and affirmation of agency in abortion decision-making, particularly in the Southern United States.

Highlights

  • Abortion is a common experience for U.S women of reproductive age—approximately 1 in 4 will have an abortion by age 45 [1]

  • The study was conducted in a county with relatively higher rates of abortion, lower access to sexual and reproductive health services, higher religiosity, and greater denominational diversity compared to other counties in the state

  • Religious and moral beliefs, and pastoral care transparency, we provide the study interview guide and codebook as Supporting Information files

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Summary

Introduction

Abortion is a common experience for U.S women of reproductive age—approximately 1 in 4 will have an abortion by age 45 [1]. In the United States, 13.5 abortions per 1,000 women of reproductive age were reported in 2017. In 2019, Georgia legislators introduced HB 481, a bill that sought to outlaw abortion once a fetal heartbeat is detected [10]. This bill aimed to restrict abortion as early as 6 weeks gestation, before many people know they are pregnant [11]—one of the strictest abortion bans in the nation [12]. A federal judge granted an injunction in early October 2019, which blocked the law while it is argued in court [13]

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