Women’s experiences using drugs to induce abortion acquired in the informal sector in Colombia: qualitative interviews with users in Bogotá and the Coffee Axis

Abstract

In 2006, abortion in Colombia was decriminalised under certain circumstances. Yet some women continue to avail themselves of ways to terminate pregnancies outside of the formal health system. In-depth interviews (IDIs) with women who acquired drugs outside of health facilities to terminate their pregnancies (n = 47) were conducted in Bogotá and the Coffee Axis in 2018. Respondents were recruited when they sought postabortion care at a health facility. This analysis examines women's experiences with medication acquired outside of the health system for a termination: how they obtained the medication, what they received, how they were instructed to use the pills, the symptoms they were told to expect, and their abortion experiences. Respondents purchased the drugs in drug stores, online, from street vendors, or through contacts in their social networks. Women who used online vendors more commonly received the minimum dose of misoprostol according to WHO guidelines to complete the abortion (800 mcg) and received more detailed instructions and information about what to expect than women who bought the drug elsewhere. Common instructions were to take the pills orally and vaginally; most women received incomplete information about what to expect. Most women seeking care did not have a complete abortion before coming to the health facility (they never started bleeding or had an incomplete abortion). Women still face multiple barriers to safe abortion in Colombia; policymakers should promote better awareness about legal abortion availability, access to quality medication and complete information about misoprostol use for women to terminate unwanted pregnancies safely.

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“…Many pregnant people have cited mistreatment by health practitioners, denial of services, and fear of being reported to the police, as barriers to legal abortions. 1 Recent evidence suggests that barriers to abortion care have deepened throughout the pandemic. 2 Mobility restrictions introduced by the government in response to COVID-19 resulted in more pregnant people delaying their abortions.…”

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“…The Guttmacher Institute has used qualitative inquiry as a systematic approach to understanding the social and cognitive processes that drive people's sexual and reproductive health (SRH) behaviors and outcomes for decades [47][48][49][50]. The Qualitative Transparency checklist was developed as a part of a larger initiative at the Guttmacher Institute to begin incorporating reproducible practices into its quantitative workflows and publicly sharing the data and code that underlie its quantitative analyses.…”