Abstract
This qualitative study aimed to examine how abortion clients in Nigeria perceive abortion and explore the role their beliefs and fears play in their care-seeking experiences and interactions with providers. Abortion is severely legally restricted in Nigeria but remains common. We conducted in-depth interviews with 25 people who obtained abortion services through three distinct models of care. We coded interview transcripts and conducted thematic analysis. Clients perceived negative attitudes toward abortion in their communities, though clients’ own beliefs were more nuanced. Clients recounted a range of fears, and nearly all mentioned worrying that they might die as a result of their abortion. Despite their concerns, clients relied on social networks and word-of-mouth recommendations to identify providers they perceived as trustworthy and safe. Kind and non-judgmental treatment, clear instructions, open communication, and reassurance of privacy and confidentiality by providers alleviated client fears and helped clients feel supported throughout their abortion process. Within restrictive contexts, the mobilization of information networks, provision of high-quality care through innovative models, and personalization of care to individual needs can assuage fears and contribute to reducing stigma and increasing access to safe abortion services.
Highlights
Induced abortion is common globally, with an estimated one in four pregnancies ending in abortion, and has been affirmed as a human right [1, 2]
In Zambia, a study found that the advice and knowledge of close confidants and community members influenced people’s pathways to abortion care and choice of service provider, such as through insider knowledge of the healthcare system [33]. This qualitative study aimed to examine how abortion clients from a range of care models in Nigeria perceive abortion and explore the role their beliefs and fears play in their care-seeking experiences and interactions with providers
Fifteen participants—all of those recruited through the safe abortion hotline and proprietary and patent medicine vendors (PPMVs)—had a medication abortion, and all 10 clients recruited from clinics had a procedural abortion
Summary
Induced abortion is common globally, with an estimated one in four pregnancies ending in abortion, and has been affirmed as a human right [1, 2]. 450 million women—representing 27 percent of women of reproductive age worldwide—live under the most restrictive categories of laws that limit their ability to exercise their right to abortion, permitting abortion only to save the pregnant person’s life or prohibiting abortion altogether [3]. There are 18 countries throughout the African region with restrictive laws in these categories [3]. In Nigeria, the penal and criminal codes prohibit abortion in all cases except when performed to save the life. Perceptions, fears, and experiences of abortion clients in Nigeria
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