Work

Women’s experiences of post-abortion care services at health facilities in Somaliland – A qualitative study among women with incomplete abortion

Year: 2025

Type: article

Abstract: • Strengthening husbands/partners knowledge is crucial to promoting timely access to post-abortion care (PAC) and reducing the risk of complications. • Post Abortion care providers require capacity building which is essential for improving sexual and reproductive health services to ensure quality PAC delivery. • Many women use traditional herbs as a first-line response to miscarriage, delaying access to medical care. • The involvement of traditional birth attendants often contributes to a delay in accessing medical care which increases the risk of maternal health complications. • Key components of the PAC package—counselling and family planning services—are largely absent, while the emergency treatment component is inconsistently delivered. Somaliland faces one of the highest maternal mortality and morbidity rates globally. Access to high-quality post-abortion care is essential for managing complications arising from incomplete abortions, including those following miscarriages. This study aimed to explore women’s experiences of incomplete abortion and their encounters with Post abortion care (PAC) services in public healthcare facilities. An inductive qualitative design was employed. In-depth interviews were conducted with women who had experienced incomplete abortions and received PAC. Data were analysed using thematic analysis guided by an inductive approach. Two key themes emerged from the analysis:(i) Women’s understanding of incomplete abortion and barriers to accessing PAC – This theme explores women’s care seeking and perceptions of causes of miscarriage, the challenges faced in accessing PAC, and the enabling factors that supported their care-seeking behaviour. (ii) Perceptions of care quality and suggestions for improvement – This theme captures women’s experiences with the quality and accessibility of PAC services and their recommendations for improving service delivery. The study highlights the vital role of family and friend in encouraging women to seek care. However, it reveals significant gaps, particularly in counselling, community awareness, and emergency care. Many women reported continued pain and bleeding after discharge, indicating the need for service improvement. Further quantitative research is needed to assess the capacity of health facilities to deliver comprehensive PAC. The Health authority and policy maker should support further research and increase investment in midwifery training and continuous professional development to improve access to and quality of PAC.

Source: Sexual & Reproductive Healthcare

DOI: 10.1016/j.srhc.2025.101136

Authors: Umulkhayr Mohamed Ismail, Fatumo Osman, Marie Klingberg-Allvin, Jama Ali Egal

Institutions: University of Hargeisa, Dalarna University, Karolinska Institutet, Birmingham City University

Language: English

Topic: Reproductive Health and Contraception

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Gender equality

Open Access status: gold

Estimated APC paid: $1,850