Self-managed abortion is a common self-care practice that enables pregnant people to exercise their rights to health, bodily autonomy and to benefit from the advances of science even when living in contexts that do not guarantee these rights. In this interpretative qualitative study, we aimed to understand women's abortion trajectories, experiences with self-managed abortion and assessments of the quality of care provided by Women Help Women (WHW, an international activist non-profit organisation working on abortion access). Grounded in feminist epistemology and health inequalities approaches, we conducted eleven semi-structured interviews in Santiago, Chile. We found that illegality, stigma and expectations surrounding motherhood and abortion determined women's experiences. Participants perceived the WHW service as good, trustworthy, fast and affordable, and valued confidentiality and privacy; the quantity and quality of information; having direct, personalised and timely communication with service staff; being treated with respect; and feeling safe, cared for and supported in their decisions. Most participants considered self-managed abortion appropriate and acceptable given their circumstances. Fear was the dominant feeling in women's narratives. Some participants mentioned missing instant communication, in-person support and professional care. We conclude that support, information and company are key to improving abortion seekers' experiences and enabling their decisions, particularly in legally restrictive settings. Centring care in pregnant people's needs and autonomy is fundamental to ensure safe, appropriate and accessible self-care interventions in reproductive health. Social and legal changes, such as public funding for abortion, destigmatisation and decriminalisation, are needed to realise people's right to higher standards of healthcare.

中文翻译：

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“没有人应该独自经历这一过程”：智利远程医疗服务中堕胎护理质量的轨迹、经验和用户看法。

自我管理堕胎是一种常见的自我保健做法，使孕妇能够行使其健康权、身体自主权，并从科学进步中受益，即使生活在不保证这些权利的环境中。在这项解释性定性研究中，我们旨在了解妇女的堕胎轨迹、自我管理堕胎的经验以及对妇女帮助妇女组织（WHW，一个致力于堕胎准入问题的国际激进非营利组织）提供的护理质量的评估。基于女权主义认识论和健康不平等方法，我们在智利圣地亚哥进行了十一次半结构化访谈。我们发现，关于孕产和堕胎的非法性、耻辱感和期望决定了女性的经历。参与者认为 WHW 服务良好、值得信赖、快速且价格实惠，并且重视保密性和隐私；信息的数量和质量；与服务人员进行直接、个性化和及时的沟通；受到尊重；并在做出决定时感到安全、受到关心和支持。大多数参与者认为，考虑到他们的情况，自我管理堕胎是适当且可以接受的。恐惧是女性叙述中的主要感受。一些参与者提到缺少即时沟通、面对面支持和专业护理。我们的结论是，支持、信息和陪伴是改善堕胎寻求者的体验并帮助他们做出决定的关键，特别是在法律限制的环境中。以孕妇的需求和自主权为中心的护理对于确保安全、适当和可及的生殖健康自我护理干预措施至关重要。需要进行社会和法律变革，例如为堕胎提供公共资金、去污名化和非刑事化，以实现人们获得更高标准医疗保健的权利。