The Interface between Abortion Practice and Community Response in Amhara Region, North Eastern Ethiopia, 2017: A cross-sectional Study

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Abstract Background The issue of abortion is as old as human existence. People have used it as a fertility control from the distant past to the present. It is a universal and global phenomenon that existing competing sociocultural discourses can influence. These discourses, in turn, have profoundly affected women's abortion experiences (reason, intentions, and decision-making process) and on the negative attitude of the community towards abortion, particularly in patriarchal societies. Objective To examine the interface between the lived experience of women and the community's attitudes towards abortion in Woldia Town, North Wollo Zone of Amhara Region, Ethiopia, in 2017. Method This study employed a mixed approach: quantitative (household survey) and qualitative (focus group discussions, in-depth interviews with key informants, and case studies) to collect relevant data. Descriptive and inferential statistics were used to analyze the quantitative data. The qualitative data were analyzed thematically and presented together with the quantitative. Result Numerous contextual and structural level factors hampered the practice of safe abortion in general, the lived experience of women who had induced abortions and the larger community's attitude towards abortion in particular. The constraining nature of such factors was more visible in abortion practice than in their enabling influence on the lives of women who performed an induced abortion. Conclusion This study claims that structural factors (religion, morality, medico-legal discourses, and gender roles) influenced the smooth functioning of safe abortion, women's reproductive rights and lived experiences on the one hand, and the community's attitude towards abortion on the other. As a result, the abortion experience of women is the result of both agency and structural level factors. Similarly, the community's negative attitude towards abortion stigmatized women in practicing induced abortion. This study's findings proposed policy implications at the agency and structural levels in addressing the prevailing problems associated with societal stigma, health complications, and psychological distress of women practicing abortion.

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