Providing safe abortion services: Experiences and perspectives of providers in South Africa

Harries, Jane; Constant, Deborah

doi:10.1016/j.bpobgyn.2019.05.005

Cited by 16 publications

(18 citation statements)

References 34 publications

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“…While rape is one of the conditions abortion is lawfully permitted in most SSA countries, abortion services are not easily accessible in most SSA countries(51), and rape is di cult to prove when cases are not reported initially. In our study context, however, safe and legal abortion is available, but societal stigma precludes women from accessing abortion services (52)(53)(54)(55).…”

Section: Discussion Of Findingsmentioning

confidence: 98%

Association Between Sexual Violence and Unintended Pregnancy Among Young Girls in South Africa

Ajayi¹,

Ezegbe²

2020

Preprint

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Abstract Background: Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of young girls (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among young girls in South Africa, a country with high teenage pregnancy rates.Methods: Drawing from cross-sectional data obtained among young girls in a South African university between June and November 2018, we estimated the magnitude of unintended pregnancy among young girls and also examined the effect of sexual violence on unintended pregnancy. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy.Results: The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (57.0%) compared to those who never experienced sexual abuse (36.8%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.76; 95% CI: 1.07–2.90).Conclusion: Addressing unintended pregnancies among young girls in South Africa requires interventions that not only increase access to contraceptive information and services, but also reduce sexual violence and cater for survivors.

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Section: Discussion Of Findingsmentioning

confidence: 98%

Association Between Sexual Violence and Unintended Pregnancy Among Young Girls in South Africa

Ajayi¹,

Ezegbe²

2020

Preprint

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“…Abortions in the second trimester (13-20 weeks) can only be performed by a doctor. Abortions are provided free of charge in public health care facilities designated to provide abortion care services [1].…”

Section: Introductionmentioning

confidence: 99%

“…Second trimester abortions using the dilatation and evacuation method are available on a limited basis. Labor induction with misoprostol used alone is the current standard of care in South Africa for second trimester abortion [1].…”

Section: Introductionmentioning

confidence: 99%

Understanding abortion seeking care outside of formal health care settings in Cape Town, South Africa: a qualitative study

et al. 2021

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Background Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, the sources of information used to make their decisions and the factors that contribute to their seeking of informal sector abortion in Cape Town, South Africa. Methods We conducted 15 semi-structured in-depth interviews in English with women who had accessed an abortion outside of the formal health care sector. Women were recruited with the assistance of a community-based key informant. Data was analyzed using a thematic analysis approach. Results Participants were aware that abortions were legal and accessible in public clinics, however they were concerned that others would find out about their unintended pregnancy and abortion if they went to legal providers. Women were also concerned about judgment and mistreatment from providers during their care. Rather than seek care in the formal sector, women looked past concerns around the safety and effectiveness of informal sector abortions and often relied on their social networks for referrals to informal providers. Conclusions The findings highlight the decision-making processes employed by women when seeking abortion services in a setting where abortion is legal and demonstrate the role of institutional and societal barriers to safe abortion access. Abortion service delivery models should adapt to women’s needs to enhance the preferences and priorities of those seeking abortion care-including those who prefer facility-based care as well as those who might prefer self-managed medical abortions.

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“…There is a debate if CO be allowed in medical practice, but with an inconclusive opinion, with few in support of not allowing to safeguard patient's right, safety and other physician's right. [1][2][3][4] There is an argument that there is no place for CO in medical profession, particularly reproductive health. 5 There is a difference in global trend with certain countries (Sweden, Iceland, Finland, Bulgaria, and Czech Republic) not allowing CO; Italy allows CO but the medical practitioner has to register their objection.…”

mentioning

confidence: 99%

“…5 There is a difference in global trend with certain countries (Sweden, Iceland, Finland, Bulgaria, and Czech Republic) not allowing CO; Italy allows CO but the medical practitioner has to register their objection. [2][3][4][5][6] Rate of CO varies between 15% (Australia) to 70% (Italy and Poland). 6,7 Majority of the countries follow a moderate path, allowing CO, but not during emergency and compromising patient safety.…”

mentioning

confidence: 99%

Conscientious objections in medicine for abortions among the undergraduate medical students: a questionnaire-based survey

Dsouza

Yalaburgi

2022

Int J Community Med Public Health

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Background: Conscientious objection (CO) in medicine, is less focused area in India.Methods: In this questionnaire-based survey, responses on voluntary abortion in general and pertaining to rape victims from the students undergoing M.B.B.S./undergraduate training program from two medical colleges was obtained. We assessed the prevalence, the influence of various factors and preference for referrals in CO towards abortion among the undergraduate medical students through a questionnaire-based survey.Results: Of 900 students approached, 765 (85.0%) (females 68%) completed and returned the questionnaire, of whom 63.5% had an urban background, 48.0% were Christians and 52.0% were non-Christians (Muslim-5.4%; Hindu-46.5%). Only 9.7% had CO (p=0.000). There was a greater acceptance to abortion irrespective of gender and residence, except for gestational age beyond 20 weeks. Non-Christians were likely to have no objections towards abortion (p<005). Christians did not have CO for congenital abnormalities in pregnancy <20 weeks (60%), raped minor, (<20 weeks, 74%; beyond 20 weeks, 61%). Among students who had CO, irrespective of religion, majority had no issues with referring the woman to another doctor. The only exception to this norm was among non-Christian students, who in case of raped minor <20 weeks, were more likely (60%) to not refer.Conclusions: CO is less prevalent among Indian medical students and is towards voluntary termination of pregnancy, pregnancy beyond 20 weeks. Medical students were considerate towards rape victims. Religion plays a significant influential role in shaping the beliefs.

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Providing safe abortion services: Experiences and perspectives of providers in South Africa

Cited by 16 publications

References 34 publications

Association Between Sexual Violence and Unintended Pregnancy Among Young Girls in South Africa

Association Between Sexual Violence and Unintended Pregnancy Among Young Girls in South Africa

Understanding abortion seeking care outside of formal health care settings in Cape Town, South Africa: a qualitative study

Conscientious objections in medicine for abortions among the undergraduate medical students: a questionnaire-based survey

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