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

dc.contributor.authorGerdts, Caitlin
dc.contributor.authorRaifman, Sarah
dc.contributor.authorDaskilewicz, Kristen
dc.contributor.authorMomberg, Mariette
dc.contributor.authorRoberts, Sarah
dc.contributor.authorHarries, Jane
dc.date.accessioned2017-10-17T08:23:20Z
dc.date.available2017-10-17T08:23:20Z
dc.date.issued2017-10-02
dc.date.updated2017-10-08T03:27:40Z
dc.description.abstractBackground: In 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. Methods: We 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. Results: We 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. Conclusions: Women 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.
dc.identifier.apacitationGerdts, C., Raifman, S., Daskilewicz, K., Momberg, M., Roberts, S., & Harries, J. (2017). Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study. <i>BMC Women's Health</i>, http://hdl.handle.net/11427/25702en_ZA
dc.identifier.chicagocitationGerdts, Caitlin, Sarah Raifman, Kristen Daskilewicz, Mariette Momberg, Sarah Roberts, and Jane Harries "Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study." <i>BMC Women's Health</i> (2017) http://hdl.handle.net/11427/25702en_ZA
dc.identifier.citationGerdts, C., Raifman, S., Daskilewicz, K., Momberg, M., Roberts, S., & Harries, J. (2017). Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study. BMC Women's Health, 17(1), 95.
dc.identifier.ris TY - Journal Article AU - Gerdts, Caitlin AU - Raifman, Sarah AU - Daskilewicz, Kristen AU - Momberg, Mariette AU - Roberts, Sarah AU - Harries, Jane AB - Background: In 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. Methods: We 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. Results: We 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. Conclusions: Women 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. DA - 2017-10-02 DB - OpenUCT DO - 10.1186/s12905-017-0443-6 DP - University of Cape Town J1 - BMC Women's Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study TI - Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study UR - http://hdl.handle.net/11427/25702 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12905-017-0443-6
dc.identifier.urihttp://hdl.handle.net/11427/25702
dc.identifier.vancouvercitationGerdts C, Raifman S, Daskilewicz K, Momberg M, Roberts S, Harries J. Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study. BMC Women's Health. 2017; http://hdl.handle.net/11427/25702.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentWomen's Health Research Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceBMC Women's Health
dc.source.urihttps://bmcwomenshealth.biomedcentral.com/
dc.subject.otherSnowball sampling
dc.subject.otherAbortion
dc.subject.otherUnsafe abortion
dc.subject.otherSouth Africa
dc.subject.otherIllegal abortion
dc.titleWomen’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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