Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study

BMC Women's Health

Research Article

Sarah Roberts¹  Caitlin Gerdts²  Sarah Raifman³  Jane Harries⁴  Mariette Momberg⁴  Kristen Daskilewicz⁴ 

[1] Advancing New Standards in Reproductive Health, University of California, 1330 Broadway, 94612, Oakland, CA, USA;Ibis Reproductive Health, 1330 Broadway, 94612, Oakland, CA, USA;University of California, San Francisco, USA;Advancing New Standards in Reproductive Health, University of California, 1330 Broadway, 94612, Oakland, CA, USA;Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Observatory, South Africa;

关键词: Snowball sampling;    Abortion;    Unsafe abortion;    South Africa;    Illegal abortion;   

DOI  :  10.1186/s12905-017-0443-6

 received in 2016-04-18, accepted in 2017-09-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn settings where abortion is legally restricted, or permitted but not widely accessible, women face significant barriers to abortion access, sometimes leading them to seek services outside legal facilities. The advent of medication abortion has further increased the prevalence of informal sector abortion. This study investigates the reasons for attempting self-induction, methods used, complications, and sources of information about informal sector abortion, and tests a specific recruitment method which could lead to improved estimates of informal sector abortion prevalence among an at-risk population.MethodsWe recruited women who have sought informal sector abortion services in Cape Town, South Africa using respondent driven sampling (RDS). An initial seed recruiter was responsible for initiating recruitment using a structured coupon system. Participants completed face-to-face questionnaires, which included information about demographics, informal sector abortion seeking, and safe abortion access needs.ResultsWe enrolled 42 women, nearly one-third of whom reported they were sex workers. Thirty-four women (81%) reported having had one informal sector abortion within the past 5 years, 14% reported having had two, and 5% reported having had three. These women consumed home remedies, herbal mixtures from traditional healers, or tablets from an unregistered provider. Twelve sought additional care for potential warning signs of complications. Privacy and fear of mistreatment at public sector facilities were among the main reported reasons for attempting informal sector abortion. Most women (67%) cited other community members as their source of information about informal sector abortion; posted signs and fliers in public spaces also served as an important source of information.ConclusionsWomen are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities. Some were unaware how or where to seek formal sector services, or believed the cost was too high. Many informal methods are ineffective and unsafe, leading to potential warning signs of complications and continued pregnancy. Sex workers may be at particular risk of unsafe abortion. Based on these results, it is essential that future studies sample women outside of the formal health sector. The use of innovative sampling methods would greatly improve our knowledge about informal sector abortion in South Africa.

【 授权许可】

CC BY   
© The Author(s). 2017