HAITI – Self-managed abortion in urban Haiti: a mixed methods study

by Erin Nicole Berry-Bibee, Clotilde Josamine St Jean, Nathan M Nickerson, Lisa B Haddad, Manuchca Marc Alcime, Eva H Lathrop

BMJ Sexual & Reproductive Health 2018;44:153-54   (not open access)

DOI: http://dx.doi.org/10.1136/bmjsrh-2017-200009


Objective Although illegal abortion is believed to be widely practised in Haiti, few data exist on such practices. We aimed to learn about illegal abortion access, methods, and perceived barriers to abortion-related care. Additionally, we aimed to identify the proportion of unscheduled antepartum visits to a public hospital that were attributable to unsafe abortion in Cap Haitien, Haiti.

Study design We conducted eight focus groups with women (n=62) and 13 interviews with women’s health providers and subsequently administered a survey to pregnant or recently pregnant women (20 weeks of gestation or less) presenting to the hospital from May 2013 to January 2014 (n=255).

Results Among the focus groups, there was widespread knowledge of misoprostol self-managed abortion. Women described use of multiple agents in combination with misoprostol. Men played key roles in abortion decision-making and in accessing misoprostol. Among the 255 pregnant or recently pregnant women surveyed, 61.2% (n=150) reported the current pregnancy was unintended and 30% (n=78) reported attempting an induced abortion. The majority of women used misoprostol either alone or as part of the medication/herb regimen for their self-managed abortion (85.1%, n=63).

Conclusions Awareness of methods to induce abortion is high among women in urban Haiti and appears to be widely practised; yet knowledge of the safest self-managed abortion options remains incomplete. Access to safer abortion services could improve maternal health in Haiti.

PHOTO: Haiti Liberté, by Haiti Grassroots Watch, 21-27 January 2015