Delays in seeking an abortion until the second trimester: a qualitative study in South Africa

Jane Harries¹ , Phyllis Orner¹ , Mosotho Gabriel² and Ellen Mitchell³

¹Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, Cape Town, South Africa

²Ipas South Africa , P.O.Box 2155, Parklands, 2121, South Africa

³Ipas, P.O. Box 5027, Chapel Hill, NC 27514, USA

author email corresponding author email

Reproductive Health 2007, 4:7doi:10.1186/1742-4755-4-7


Published:	20 September 2007

Abstract

Background

Despite changes to the South African abortion legislation in 1996, barriers to women accessing abortions still exist. Second trimester abortions, an inherently more risky procedure, continue to be 20% of all abortions. Understanding the reasons why women delay seeking an abortion until the second trimester is important for informing interventions to reduce the proportion of second trimester abortions in South Africa.

Methods

Qualitative research methods were used to collect data. Twenty-seven in-depth interviews were conducted in 2006 with women seeking a second trimester abortion at one public sector tertiary hospital and two NGO health care facilities in the greater Cape Town area, South Africa. Data were analysed using a grounded theory approach.

Results

Almost all women described multiple and interrelated factors that influenced the timing of seeking an abortion. Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health service related barriers that hindered access to abortion services.

Conclusion

Understanding the complex reasons why women delay seeking an abortion until the second trimester can inform health care interventions aimed at reducing the proportion of second trimester abortions in South Africa.