Table 2 Women’s perception of barriers to accessing safe abortion services in Southern Ethiopia

Cost of safe abortion services served as a deterrent

21

62

“Most women in this community are poor and it is not so easy for them to find 300 to 400 Birr for safe abortion.” [ 27 years-old, employed]

“The first abortion I had was unsafe. I couldn’t afford the abortion so I went to the lady [individual without the requisite skills to provide safe abortion services] but I knew the service was provided in healthcare centers, I just couldn’t afford it.” [25-years-old, employed]

“Women seek unsafe abortion because the cost is lower. Even 50 Birr might be too expensive for some women.” [22-years-old, employed]

Lack of privacy or confidentiality prevented women from going to health centers

9

26

“Women don’t come to health facilities to get an abortion because they are scared and don’t want to be seen. This is a small town and you don’t want to be seen entering SRH [sexual and reproductive health] clinics.” 27 years-old, employed]

“When I went to get a test at the clinic, there were other people around the doctor and I was too shy to tell him what my problem was. So, I told him that I had diarrhea.” [19 years-old, student]

“Women are afraid of being seen by community members, it’s a small town and people talk. There’s no confidentiality maintained by the providers.” [23-years-old, unemployed]

Fear of mistreatment by providers

9

26

“I was so scared to go and talk to the doctor at the health center about my problem. When I told him [the doctor], he insulted me. He called me a dog. But you know, I did not mind all of that abuse as long as he gave me the information on where to get my problem solved and he did. That’s all that mattered to me.” [18-years-old, student]

“I was married at the time and living with HIV. My husband and I had decided that we did not want any children. I accidently got pregnant and went to a hospital to end the pregnancy. They [doctor and nurse] told me that they had used a surgical method or something they call the vacuum to clean my uterus and even showed me an ultra sound after the procedure. But after 4 months, I felt something move. At that time, my husband was bedridden and I did not have any sexual intercourse. I went back to the hospital and the same nurse and doctor told me that I was still pregnant and it seemed like the initial procedure did not ‘go through’. When I asked them how this could have happened, they said that maybe this baby was supposed to be born. So, I ended up having my daughter.” [25-years-old, employed]

“In healthcare centers, there is a lot of mistreatment of women so women avoid going there to begin with even when they know that they should seek safe abortion services from there [health centers]” [25-years-old, employed]

Lack of information, health centers don’t advertise abortion services

7

21

“I got a pregnancy test at a health facility that provided safe abortion services, but I did not know about that until recently.” [18-years-old, employed]

“We [she and her pregnant friends] don’t come to the clinic because they [health centers] don’t advertise the service of unsafe abortion.” [18-years-old, student]

“Health care centers, including the one at the University, don’t give you enough information, you don’t feel free to talk to them and ask them about abortion.” [19-years-old, student]