Search

Barriers to accessing legal abortion services in Tunisia are increasing, despite a liberal abortion law, and women are often denied wanted legal abortion services. In this paper, we seek to explore the reasons for abortion denial and whether these reasons had a legal or medical basis. We also identify barriers women faced in accessing abortion and make recommendations for improved access to quality abortion care. We recruited women immediately after they had been turned away from legal abortion services at two facilities in Tunis, Tunisia. Thirteen women consented to participate in qualitative interviews two months after they were turned away from the facility. Women were denied abortion care on the day they were recruited due to three main reasons: gestational age, health conditions, and logistical barriers. Nine women ultimately terminated their pregnancies at another facility, and four women carried to term. None of the women attempted illegal abortion services or self-induction. Further research is needed in order to assess abortion denial from the perspective of providers and medical staff. [ABSTRACT FROM AUTHOR]

Despite Tunisia's historically progressive reproductive health policies, Tunisian women now face significant challenges accessing legal abortion. Through in-depth interviews with providers at six facilities, we explored factors influencing provider attitudes about abortion and provider perspectives about abortion morality, safety, and legality. We found that gatekeepers (counsellors and front office staff) generally believed abortion was immoral, while obstetricians and gynecologists were more likely to support an individual's right to access abortion. However, providers' actions do not necessarily align with their stated beliefs regarding abortion; some providers who said they support abortion access generally held personal beliefs about when and for whom abortion is appropriate which influenced their provision of care. System-level barriers to abortion provision, such as a lack of resources, hinder some providers who may otherwise be willing to provide the service. These system-level barriers may also account for inconsistencies between providers' beliefs and actions related to abortion. Illuminating the complexity in provider beliefs and attitudes about abortion can help us to better understand whether and why abortion care is provided, as well as the factors that ultimately determine whether a woman can obtain an abortion.