ABSTRACT

In 2006, abortion in Colombia was decriminalised under certain circumstances. Yet some women continue to avail themselves of ways to terminate pregnancies outside of the formal health system. In-depth interviews (IDIs) with women who acquired drugs outside of health facilities to terminate their pregnancies (n = 47) were conducted in Bogotá and the Coffee Axis in 2018. Respondents were recruited when they sought postabortion care at a health facility. This analysis examines women’s experiences with medication acquired outside of the health system for a termination: how they obtained the medication, what they received, how they were instructed to use the pills, the symptoms they were told to expect, and their abortion experiences. Respondents purchased the drugs in drug stores, online, from street vendors, or through contacts in their social networks. Women who used online vendors more commonly received the minimum dose of misoprostol according to WHO guidelines to complete the abortion (800 mcg) and received more detailed instructions and information about what to expect than women who bought the drug elsewhere. Common instructions were to take the pills orally and vaginally; most women received incomplete information about what to expect. Most women seeking care did not have a complete abortion before coming to the health facility (they never started bleeding or had an incomplete abortion). Women still face multiple barriers to safe abortion in Colombia; policymakers should promote better awareness about legal abortion availability, access to quality medication and complete information about misoprostol use for women to terminate unwanted pregnancies safely.

 抽象的

2006年，哥伦比亚在某些情况下将堕胎合法化。然而，一些妇女继续利用正规卫生系统之外的方式终止妊娠。 2018 年，在波哥大和咖啡轴对在医疗机构外购买药物终止妊娠的妇女 ( n = 47) 进行了深度访谈 (IDIs)。受访者在医疗机构寻求流产后护理时被招募。该分析调查了妇女在卫生系统之外获得终止妊娠药物的经历：她们如何获得药物、收到什么药物、如何指导她们使用药物、她们被告知要出现的症状以及她们的堕胎经历。受访者在药店、网上、街头小贩或通过社交网络中的联系人购买了这些药物。与在其他地方购买药物的女性相比，使用在线供应商的女性更常接受根据世界卫生组织指南完成堕胎的最低剂量的米索前列醇（800 微克），并且获得更详细的说明和有关预期结果的信息。常见的说明是口服和阴道服药。大多数妇女收到的有关预期结果的信息不完整。大多数寻求治疗的妇女在来到医疗机构之前没有进行过完全流产（她们从未开始流血或进行过不完全流产）。哥伦比亚妇女在安全堕胎方面仍然面临多重障碍；政策制定者应提高人们对合法堕胎的认识、获得优质药物的机会以及有关妇女使用米索前列醇安全终止意外怀孕的完整信息。