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. 2022 Aug 26;19(1):185.
doi: 10.1186/s12978-022-01488-6.

Abortion beyond 13 weeks in Argentina: healthcare seeking experiences during self-managed abortion accompanied by the Socorristas en Red

Brianna Keefe-Oates  1   2 , Chelsea G Tejada  3 , Ruth Zurbriggen  4 , Belén Grosso  4 , Caitlin Gerdts  5
Affiliations

Abortion beyond 13 weeks in Argentina: healthcare seeking experiences during self-managed abortion accompanied by the Socorristas en Red

Brianna Keefe-Oates et al. Reprod Health. .

Abstract
in English, Spanish

Background: In Argentina, a group of feminist activists, the Socorristas en Red, provide information and accompaniment to people seeking abortions, including beyond 13 weeks gestation. Recently-released WHO guidelines for abortion care acknowledge that abortion trajectories vary and people may seek services and support from a range of settings in the process of an abortion. It follows, therefore, that people who self manage abortions beyond 13 weeks with the support of accompaniment groups may interact with health professionals in the public and/or private sector. Understanding the reasons for and experiences with these interactions can help to inform best practice.

Methods: In 2016, we conducted 23 exploratory interviews among women who self managed abortions beyond 13 weeks gestation accompanied by Socorristas, to understand healthcare-seeking decisions and experiences. We used narrative inquiry as an interview technique and coded interviews using first a holistic coding and, second, a content analysis technique to identify emergent themes in the text and subsequently identify themes relevant to study aims.

Results: We found that many participants had disclosed their abortion intentions to health professionals prior to their abortions. Some were provided with emotional support and referrals to the Socorristas, while others were admonished and warned of serious health consequences. Most participants sought post-abortion care in public or private-sector health facilities; for fear of legal repercussions, many participants did not share that they had used abortion medications with post-abortion care providers. During care seeking, some participants reported poor treatment, in several cases because they were suspected of inducing abortion, while others reported supportive care from health professionals who had previously-established relationships with the Socorristas.

Conclusions: This study illuminates the important role that supportive health professionals can play to ensure that, regardless of the trajectory of an abortion, people feel comfortable accessing clinical services during their abortion process, even in restrictive settings. Feminist activists can help build bridges with the medical system to ensure that providers who interact with people seeking abortion-related services are empathic, understand their legal rights, and provide supportive care.

INTRODUCCIóN: En Argentina, una red de colectivas feministas, las Socorristas en Red, brindan información y acompañamiento a las personas que buscan abortos, incluso más allá de las 13 semanas de gestación. La nueva guía de la OMS para la atención en el aborto reconoce que las trayectorias del aborto varían y las personas pueden buscar servicios y apoyo en una variedad de entornos en el proceso de un aborto. Las personas que autogestionan abortos más allá de las 13 semanas con el apoyo de grupos de acompañamiento podrán interactuar con profesionales del sector médico. Comprender las razones y las experiencias con estas interacciones puede ayudar a mejorar las prácticas. MéTODOS: Realizamos 23 entrevistas en 2016 con mujeres que tuvieron abortos después de las 13 semanas usando medicamentos fuera de un entorno clínico acompañadas por Socorristas, para comprender las decisiones y experiencias con el sistema de salud. Utilizamos la indagación narrativa como técnica de entrevista y codificamos entrevistas utilizando las técnicas de codificación holística y análisis de contenido para identificar los temas emergentes en el texto y luego identificar temas relevantes a los objetivos del estudio. RESULTADOS: Antes del aborto, muchas mujeres revelaron sus intenciones a los profesionales de la salud; algunos brindaron apoyo emocional y referencias a las Socorristas, y otros las amonestaron y advirtieron sobre consecuencias para la salud. La mayoría de las mujeres buscaron atención postaborto; muchas temían repercusiones legales al buscar atención y no dijeron que habían usado medicamentos. Durante la búsqueda de atención, algunas mujeres reportaron mal trato, en varios casos porque se sospechaba que inducían el aborto, mientras que otras reportaron apoyo por parte de profesionales de la salud que colaboraban previamente con las Socorristas. CONCLUSIONES: Este estudio demuestra cómo los profesionales de la salud que brindan apoyo pueden ayudar a garantizar que las personas que buscan servicios de aborto se sientan cómodas al acceder a los servicios clínicos en entornos restrictivos. Las activistas feministas pueden ayudar a construir puentes con el sistema de salud para garantizar que los profesionales de salud sean empáticas, respetan los derechos legales y brinden atención de apoyo.

Keywords: Activism; Argentina; Health services; Reproductive health; Self-managed abortion.

Plain language summary

Before 2021, Argentina’s laws prohibited abortion except in limited circumstances. A feminist activist group, the Socorristas en Red, provided information and support to people seeking abortion services, including those beyond 13 weeks gestation. Recently-released WHO guidelines for abortion care acknowledge that abortion trajectories vary and people may seek services and support from a range of settings in the process of a single abortion (World Health Organization, 2022). It follows, therefore, that people who self manage abortions beyond 13 weeks with the support of accompaniment groups may interact with health professionals in the public and/or private sector. Understanding reasons for and experiences with these interactions can help improve quality of abortion care and inform best practice. We conducted interviews with people who used medications for abortion in the second trimester supported by the Socorristas and analyzed their stories about abortion-related healthcare. Participants in our study sought healthcare services in clinics at various timepoints: many visited providers when first considering abortion, and most went to providers for post-abortion care. Some providers admonished their patients for seeking abortion services, while others provided referrals to the Socorristas. Many participants were concerned about their legal safety, and feared prosecution when they received healthcare services, especially if seeking care after the abortion. In these instances, some participants experienced poor quality or inappropriate care because they did not feel safe sharing that they had taken medications for abortion, and others were treated poorly because of the abortion. The experiences of those who sought services from health professionals who had established relationships with the Socorristas appeared to be more positive than the others. This study illuminates the important role that supportive health professionals can play to ensure that, regardless of the trajectory of an abortion, people feel comfortable accessing clinical services during the course of an abortion, even in restrictive settings, and how feminist activists can help to ensure providers are empathic and provide supportive care to all those who have abortions.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

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