Doctoral candidate, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; Research Coordinator, Women Help Women, Amsterdam, Netherlands.
Associate Academic, Departamento Promoción de la Salud de la Mujer y el Recién Nacido, Facultad de Medicina Norte, Universidad de Chile, Santiago, Chile; Evaluator, Inclusión y Equidad, Santiago, Chile.
Sex Reprod Health Matters. 2021;29(3):1948953. doi: 10.1080/26410397.2021.1948953.
Self-managed abortion is a common self-care practice that enables pregnant people to exercise their rights to health, bodily autonomy and to benefit from the advances of science even when living in contexts that do not guarantee these rights. In this interpretative qualitative study, we aimed to understand women's abortion trajectories, experiences with self-managed abortion and assessments of the quality of care provided by Women Help Women (WHW, an international activist non-profit organisation working on abortion access). Grounded in feminist epistemology and health inequalities approaches, we conducted eleven semi-structured interviews in Santiago, Chile. We found that illegality, stigma and expectations surrounding motherhood and abortion determined women's experiences. Participants perceived the WHW service as good, trustworthy, fast and affordable, and valued confidentiality and privacy; the quantity and quality of information; having direct, personalised and timely communication with service staff; being treated with respect; and feeling safe, cared for and supported in their decisions. Most participants considered self-managed abortion appropriate and acceptable given their circumstances. Fear was the dominant feeling in women's narratives. Some participants mentioned missing instant communication, in-person support and professional care. We conclude that support, information and company are key to improving abortion seekers' experiences and enabling their decisions, particularly in legally restrictive settings. Centring care in pregnant people's needs and autonomy is fundamental to ensure safe, appropriate and accessible self-care interventions in reproductive health. Social and legal changes, such as public funding for abortion, destigmatisation and decriminalisation, are needed to realise people's right to higher standards of healthcare.
自主堕胎是一种常见的自我保健实践，使孕妇能够行使自己的健康权、身体自主权，并从科学进步中受益，即使在不保障这些权利的环境中也是如此。在这项解释性定性研究中，我们旨在了解妇女的堕胎轨迹、自主堕胎的经验以及对妇女帮助妇女（WHW，一个致力于堕胎获取的国际激进非营利组织）提供的护理质量的评估。我们的研究扎根于女权主义认识论和健康不平等方法，在智利圣地亚哥进行了 11 次半结构化访谈。我们发现，非法性、耻辱感以及对母性和堕胎的期望决定了妇女的经验。参与者认为 WHW 服务质量好、值得信赖、快速且负担得起，并重视保密性和隐私；信息的数量和质量；与服务人员进行直接、个性化和及时的沟通；受到尊重；在决策中感到安全、受到关怀和支持。大多数参与者认为，鉴于她们的情况，自主堕胎是合适和可以接受的。恐惧是妇女叙述中的主导情绪。一些参与者提到缺少即时沟通、面对面支持和专业护理。我们的结论是，支持、信息和陪伴是改善堕胎寻求者体验和使她们能够做出决定的关键，特别是在法律限制的环境中。以孕妇的需求和自主权为中心是确保生殖健康中安全、适当和可及的自我保健干预的基础。需要进行社会和法律变革，如为堕胎提供公共资金、消除耻辱化和非刑罪化，以实现人们获得更高标准医疗保健的权利。
