\u2018I felt the world crash down on me\u2019: Women\u2019s experiences being denied legal abortion in Colombia

Teresa Depiñeres,Margoth Mora,Diana Greene Foster,Sarah Raifman,Cristina Villarreal,Caitlin Gerdts

doi:10.1186/s12978-017-0391-5

Abstract

BackgroundIn 2006, Colombia’s constitutional court overturned a complete ban on abortion, liberalizing the procedure. Despite a relatively liberal new law, women still struggle to access safe and legal abortion services. We aimed to understand why women are denied services in Colombia, and what factors determine if and how they ultimately terminate pregnancies.MethodsWe recruited women denied abortion at a private facility in Bogota. Twenty-one participants completed an initial interview and eight completed a second longer interview. Two researchers documented themes and developed and applied a codebook to transcripts using ATLAS.ti.ResultsParticipants faced barriers, such as lack of knowledge of service availability and delayed pregnancy recognition, leading to denial. Five out of eight participants ultimately received abortions in public hospitals, due to support from partners and a robust referral system; nevertheless, they received poor care. Those who continued pregnancies endured stigmatizing events and inaccurate medical counselling at referral facilities. Several women contemplated illegal abortion though were afraid to attempt it.ConclusionWe propose the following recommendations: 1) increase awareness about availability and legality of abortion services to prevent delay and consequent denial; 2) provide counseling and referral upon denial; and 3) train providers in interpersonal quality abortion care.

Highlights

In 2006, Colombia’s constitutional court overturned a complete ban on abortion, liberalizing the procedure
Plain English summary In Colombia, abortion services are authorized by the federal government, with no specific gestational age limitations, except that services after 15 weeks must be performed at a high level facility
In Colombia, one third of unsafe abortions result in complications that require medical attention, primarily heavy bleeding and incomplete abortion, and rates are even higher among women who self-induce using invasive techniques or seek help from an unqualified practitioner [4]

Summary

Introduction

In 2006, Colombia’s constitutional court overturned a complete ban on abortion, liberalizing the procedure. In Colombia, one third of unsafe abortions result in complications that require medical attention, primarily heavy bleeding and incomplete abortion, and rates are even higher among women who self-induce using invasive techniques or seek help from an unqualified practitioner [4]. In 2006, Colombia’s Constitutional Court overturned a complete ban on abortion, decriminalizing the procedure in cases of rape or incest, foetal anomaly incompatible with life, and endangerment of the life or health of the woman [5]. The law does not include gestational age limits [8], but Ministry of Health protocol states that abortion services up to 15 weeks may be provided at the primary health service level, and services after 15 weeks must be performed at a higher level facility [6]

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