Addressing abortion stigma in service delivery: the experience of Pakistan and Burkina Faso
Rebecca Wilkins1, Asifa Khanum2 1International Planned Parenthood Federation, London, UK, 2Rahnuma Family Planning Association of Pakistan, Lahore, Pakistan - firstname.lastname@example.org
Restrictive legislation and limited service provision remain obstacles to women who seek abortion services. These obstacles are worsened by the impact of abortion stigma and associated secrecy, shame, guilt and fear. Stigma prevents or delays access to safe abortion services as well as making lawmakers reluctant to improve legislation to facilitate access to abortion information and services. As part of its commitment to reducing abortion stigma at all levels, IPPF commissioned research to understand its effect on women accessing services through IPPF Member Association clinics. In-depth qualitative research using semi-structured interviews with abortion clients, service providers and client partners was conducted at Member Association clinics in Pakistan and Burkina Faso. The research aimed to identify the specific causes and manifestations of abortion stigma and to inform interventions designed to reduce abortion stigma. The research found commonalities in abortion stigma in Pakistan and Burkina Faso, as well as some issues that were unique to each country setting. The clinic client pathways, misconceptions and lack of knowledge about abortion, pre-abortion counselling, and the timeliness of seeking medical care were among some of the issues found to have an impact on, or were impacted by clients' experience of stigma. In both countries women who accessed abortion services had a high level of self-stigma which impacted on their expectations of quality of care in the clinics. Abortion stigma is an unspoken reality that significantly impacts both the attitudes and practices of medical professionals and women who access abortion services. However, the nature of abortion and the stigma surrounding it makes this a challenging topic to collect data and information on. The research findings illustrate the need for the pilot testing of interventions at both the community and service delivery levels in order to address abortion stigma through a more comprehensive and systematic approach.