Jewkes Rachel K, Gumede Tebogo, Westaway Margaret S, Dickson Kim, Brown Heather, Rees Helen
Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa.
BJOG. 2005 Sep;112(9):1236-42. doi: 10.1111/j.1471-0528.2005.00697.x.
To explore why South African women still abort outside designated services where there is substantial legal service provision.
Descriptive study.
Three hospitals in Gauteng Province in South Africa. Sample Forty-six women attending hospital with incomplete abortion who had abortions induced outside of designated facilities.
An interviewer-administered questionnaire with open and closed questions was completed. Induction status was determined from answers to a set of closed questions. Open-ended questions explored the circumstances of induction. Main focus of interviews Methods of induction used, barriers to legal service use.
Nearly two-thirds of women (n= 38) had self-induced or had consulted a traditional healer. A minority of these women (n= 11) indicated that they did this because they experienced barriers to legal service use. For others it was presented as a 'natural' response to a health problem (unwanted pregnancy). Several women (n= 10) were given misoprostol by a doctor, nurse, or pharmacist. Fifty-four percent of the women had not used legal services because they did not know about the law, while 15% knew of their legal rights, but did not know of a legal facility. Others did know where to access legal services but feared rude staff (17%) or breaches of confidentiality (6.5%). Others (6.5%) had been unable to get a legal abortion early enough in pregnancy to comply with the law.
Lack of information on abortion rights under the Act and perceived poor quality of designated facilities were the most important barriers to access and should be addressed by policymakers and health service management. The willingness of women to self-medicate and visit traditional healers in these circumstances may influence the overall ability of the new legislation to reduce abortion morbidity.
探讨为何在有大量合法服务提供的情况下，南非女性仍在指定服务之外进行堕胎。
描述性研究。
南非豪登省的三家医院。样本：46名因不完全流产到医院就诊且在指定设施外进行堕胎的女性。
完成一份由访谈者管理的包含开放式和封闭式问题的问卷。根据一组封闭式问题的答案确定引产情况。开放式问题探讨引产的情况。访谈的主要重点：使用的引产方法、使用法律服务的障碍。
近三分之二的女性（n = 38）自行引产或咨询过传统治疗师。这些女性中少数人（n = 11）表示这样做是因为她们在使用法律服务时遇到了障碍。对其他人来说，这是对健康问题（意外怀孕）的“自然”反应。有几位女性（n = 10）从医生、护士或药剂师那里获得了米索前列醇。54%的女性未使用法律服务是因为她们不了解法律，而15%的人知道自己的合法权利，但不知道合法机构。其他人确实知道从哪里获得法律服务，但担心工作人员态度粗鲁（17%）或保密性被侵犯（6.5%）。其他人（6.5%）在怀孕早期无法及时获得合法堕胎以符合法律规定。
《堕胎法》下堕胎权利信息的缺乏以及指定设施质量不佳是获取服务的最重要障碍，政策制定者和卫生服务管理人员应加以解决。在这种情况下，女性自行用药和拜访传统治疗师的意愿可能会影响新立法降低堕胎发病率的总体能力。
