Why women seek abortion? a qualitative study on perspectives of rural women on abortion and contraception

Background:Induced abortions have been a sensitive issue throughout the world and the reasons for which women seek abortion is diverse and depends on many social and economical factors. In India, most of the rural women are still not aware of their rights and needs regarding abortion and consider abortion as illegal. Exploring the perspectives of rural women regarding induced abortions using qualitative methodology would help us to understand their attitude towards abortion and guide us towards educating women to adopt a favorable attitude towards safe abortion and contraception. The aim of this study was to explore the rural woman’s perspective of their rights and needs in relation to abortion and attitudes and beliefs regarding contraception Methods: A descriptive qualitative study done in Sri Manakula Vinayagar Medical College & Hospital. Nine, purposively selected rural women attending family welfare clinic for seeking termination of pregnancy after having experienced at least one or more previous abortions were subjected to in-depth interview. The participants of the study were duly counseled and informed consent was taken prior to the in-depth interview. Semi-structured guideline was used for data collection, which included background characteristics, the reasons for seeking multiple abortions and perception of their rights and needs regarding abortion and their beliefs and attitude regarding contraception. In-depth interview was carried out in Tamil and translated to English by the authors The evolving themes were summarized and manual content analysis was done.Results:The age group of our respondents was between 22-30 years and eight respondents were multiparous whereas one respondent was a nullipara. Among the 9 respondents, 4 had a previous history of unsupervised medical abortion. The most common reason cited for repeated abortions was unwanted pregnancy due to completion of the family followed by other reasons like lack of spacing, health, financial and social reasons. In majority of the respondents both the husband and wife were involved in the decision making process but husband had the final authority. Women experienced a lot of emotional turmoil during the abortion process and feeling of guilt and pain was quite common. Most of the respondents used natural methods of contraception and many misconceptions prevailed regarding the use of contraceptives. Awareness of the legal status of abortion, the time limit and indications for legal abortions was almost negligible in these women.Conclusion: These findings highlight the need to improve rural women’s knowledge of fertility and contraception. Media and service providers should use every possible opportunity to educate women regarding the legal status of abortion and to promote contraceptive usage by creating awareness regarding safety and free availability of various contraceptives thereby clearing misconceptions regarding contraception. There is a need to educate rural women that use of a regular contraceptive method is better than undergoing repeated abortions