Health professionals’ perspectives on delays in seeking abortion care in Tigray, Ethiopia: a qualitative study

Abstract

Background: Globally an estimated 42 million abortions are performed each year, and 20 million of them are considered unsafe because they are performed by unskilled providers and/or in unsanitary conditions. Despite the fact that higher proportion of maternal death is associated with second trimester abortion, it has been reported that only 9–10% of health facilities do have second trimester abortion service and service providers.

Methods: A qualitative descriptive study was conducted employing focus group discussions (six) among health professionals who engaged in rendering services related to abortion care. ATLAS.ti software was used for analysis and themes were generated.

Results: Lack of awareness, decision dilemma, economic reasons, fear of disclosing the case to family in case of rape and lack of access to care were among the causes of late abortion mentioned by the focused group discussants,  thus affecting the timing when the abortion was carried out. Though there are challenges, all participants believe that their respective health facility is working according to the national abortion law. Awareness creation about the benefits of early abortion and risks of late abortion; availing health centers rendering second trimester abortion services, promotion of availability of safe and free abortion service in public facilities, and promotion of family planning service for the vulnerable population were among the repeatedly mentioned suggested solutions.

Conclusion and recommendation: According to the focused group discussion of the health professionals’ reasons why women delayed seeking an abortion were multifaceted and interconnected. Improving awareness of women about availability of free safe abortion services, and increasing access of services may alleviate the problem of delay in seeking abortion.