Navigating abortion law dilemmas: experiences and attitudes among Ethiopian health care professionals

Background Ethiopia’s 2005 abortion law improved access to legal abortion. In this study we examine the experiences of abortion providers with the revised abortion law, including how they view and resolve perceived moral challenges. Methods Thirty healthcare professionals involved in abortion provisions in Addis Ababa were interviewed. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework. Results Most participants considered the 2005 abortion law a clear improvement—yet it does not solve all problems and has led to new dilemmas. As a main finding, the law appears to have opened a large space for professionals’ individual interpretation and discretion concerning whether criteria for abortion are met or not. Regarding abortion for fetal abnormalities, participants support the woman’s authority in deciding whether to choose abortion or not, although several saw these decisions as moral dilemmas. All thought that abortion was a justified choice when a diagnosis of fetal abnormality had been made. Conclusion Ethiopian practitioners experience moral dilemmas in connection with abortion. The law places significant authority, burden and responsibility on each practitioner.

Abortion in Countries with Restrictive Abortion Laws—Possible Directions and Solutions from the Perspective of Poland

The tendency towards the radicalization of abortion law is observed in numerous countries, including Poland. The aim of the present paper was to determine the main factors influencing the number of abortions performed worldwide and to indicate the main directions which should be followed to improve the patients’ well-being. The authors conducted their search in the PubMed of the National Library of Medicine and Google Scholar. Databases were extensively searched for all original and review articles/book chapters in English until June 2021. The main problems associated with the contemporary policy of birth regulation include no possibility of undergoing a termination because of the conscience clause invoked by the medical personnel, restrictive abortion law and lack of sexual education. Minimal changes that should be considered are: improved sex education and the availability of contraception, free access to abortion-inducing drugs with adequate information provided by qualified medical personnel in countries with a conscience clause invoked by the personnel, and the development of an international network which would facilitate undergoing a pregnancy termination abroad to provide women with access to legal abortion assisted by professional medical personnel.

Safe abortion practice and knowledge on abortion legalization among Nepalese undergraduate female students

Background: Unsafe abortion remains one of the major public health problems, especially in developing countries. The objective of this study was to assess the level of knowledge on the legalization of abortion and the practice of abortion among Nepalese undergraduate female students. Methods: An analytical cross-sectional study was conducted among the 490 female students of Pokhara Valley, Nepal. Study populations from the 10 colleges were selected through purposive and systematic random sampling. The semi-structured questionnaire was used as a data collection technique. Results: Only 34% of students have a good knowledge of abortion legalization, compared to 42% who have poor knowledge. While two-thirds of the participants (66.6%) were aware that abortion is legal in Nepal, only a few were aware of the conditions for legalized safe abortion. During sexual intercourse, almost half of the participants (51.3%) did not use any form of contraception. Unintended conception was the primary cause of abortion (53.3%). Conclusion: The level of knowledge about the abortion law, safe abortion practice, and utilization of abortion services were found to be poor. Age of the participant, autonomy level for decision making, religion, and study background were the associated factors with the level of knowledge and practice of abortion. Community-based health promotion and awareness programs focusing on the youth population should be conducted.

Revisiting Polish Abortion Law: Doctors and Institutions in a Restrictive Regime

This article examines the motivations of doctors operating in restrictive abortion regimes, and it takes Poland as a case study. It places in the foreground institutional and intra-professional factors that determine abortion healthcare, which to date have been accorded little attention. The article compares the impact that criminal, professional, and social sanctions have upon the provision of abortion services. In so doing, its purpose is to refocus debate in this area. It aims to move the emphasis away from legal and political factors, including the criminalisation of abortion, and to place it on medical agency. The Polish case study is examined to test out, in the context of a late-transitional polity, the sustainability of neo-institutionalist approaches to the study of law and organisations and the sociology of professions. The analysis is particularly important and urgent in light of the recent retrenchment of reproductive rights in Poland, and beyond.

Women Leaders Perceived Barriers and Consequences of Safe Abortion in Rwanda: A Qualitative Study

Background: Between 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how to access safe abortion services. They often do not have the power to make informed decisions on the subject. The purpose of this study is to explore the barriers and consequences of safe abortion as perceived by women leaders in Rwanda. Method: In this qualitative study, seven focus group discussions and seven key informant interviews were performed in October 2019. A total of 51 women leaders participated, their age ranging from 38 to 60 years. Participants were drawn from three districts, namely Gasabo, Kicukiro, and Nyarugenge. For variability of data, participants came from parliament, government ministries, government parastatals, and civil society organizations. All interviews were conducted in Kinyarwanda and later translated into English. Data were analyzed using qualitative content analysis. Results: The emerging theme “strong barriers and numerous consequences of safe abortion” illustrates how women leaders perceive barriers to safe abortion and its related consequences in Rwanda. The theme is divided into two categories: 1) “Perceived barriers of safe abortion” and 2) “Consequences of providing safe abortion”. The sub-categories for the first category are “Reluctance to fully support safe abortion due to perceived unjustified abortions”, “Abortion-related stigma, “Abortion is against cultural and religious beliefs”, and “Emotional attachment to the unborn”. The sub-categories for the second category are “Perceived physiological trauma”, “cause for barrenness/infertility”, “increase in services abuse by adolescents/women”, “increase of workload for healthcare providers”, “increase in sexual activities and STIs”, and “Abortion-related physiological trauma”. Conclusion: The subject of safe abortion evokes mixed reactions among participants, and is entangled with unsafe abortion in most cases. Participants stress that the word ‘abortion’ disturbs, regardless of whether it relates to being safe or unsafe. Participants believe the word ‘abortion’ outweighs the word ‘safe’. Societal expectations play a major role in the decision-making process of any adolescent or a family member faced with a pregnant adolescent regardless of the existing safe abortion law. Community mobilization and sensitization are crucial if safe abortion in accordance with abortion law is to be embraced. Messages that reinforce safe abortion as acceptable and address stigma, fears of trauma, and barrenness should be developed to educate adolescents, parents, and women leaders about safe abortion, to mitigate unsafe abortion-related complications.