Abstract

Medication abortion, a safe and effective method for terminating pregnancy in the first and second trimester, can reduce overall maternal mortality. However, little is known about how advocates for abortion view medication abortion in their communities, particularly where abortion is legally restricted. We conducted in-depth interviews (2018-2019; N=24) with health workers and community leaders in the Democratic Republic of the Congo, Kenya, Nigeria, Malawi, and Tanzania identified from the Mobilizing Activists Around Medication Abortion (MAMA) network. Interviews focused on the role of advocacy in medication abortion provision. Participants identified benefits of medication abortion to women, including privacy, accessibility, and safety, and community benefits, including perceived reduction in maternal mortality. Participants described challenges to providing support for medication abortion, including difficulties operating in legally restrictive environments and stigma. Findings highlight the role of grassroots advocacy to overcome challenges and provide an alternative model of abortion access and care to women.

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