title: Unsafe abortion requiring hospital admission in the Eastern Highlands of Papua New Guinea--a descriptive study of women's and health care workers' experiences.
abstract: BACKGROUND
  In Papua New Guinea induced abortion is restricted under the Criminal Code Law. Unsafe abortions are known to be widely practiced and sepsis due to unsafe abortion is a leading cause of maternal mortality.
  
  
  METHODS
  We undertook a six month, prospective, mixed methods study at the Eastern Highlands Provincial Hospital. Semi structured and in depth interviews were undertaken with women presenting following induced abortion. This paper describes the reasons why women resorted to unsafe abortion, the techniques used, decision to seek post abortion care and women's reflections post abortion.
  
  
  RESULTS
  28 women were admitted to hospital following an induced abortion. Reasons for inducing an abortion included: wanting to continue with studies, relationship problems and socio-cultural factors. Misoprostol was the most frequently used method to end the pregnancy. Physical and mechanical means, traditional herbs and spiritual beliefs were also reported. Women sought care post abortion due to excessive vaginal bleeding, and severe abdominal pain with some afraid they would die if they did not seek help.
  
  
  CONCLUSIONS
  In the absence of contraceptive information and services to avoid, postpone or space pregnancies, women in this setting are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk. Women need access to safe, effective means of abortion.
authors.affiliation: Australian Centre of Tropical Medicine and Health, James Cook University, Townsville, QLD, Australia. lmvallely@yahoo.com.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vallely
authors.affiliation: Sexual & Reproductive Health Unit, Papua New Guinea Institute of Medical Research, PO Box 60, Goroka, 441, Eastern Highlands Province, Papua New Guinea. primrose.homiehombo@pngimr.org.pg.
authors.forename: Primrose
authors.initials: P
authors.lastname: Homiehombo
authors.affiliation: Sexual & Reproductive Health Unit, Papua New Guinea Institute of Medical Research, PO Box 60, Goroka, 441, Eastern Highlands Province, Papua New Guinea. a.Kelly@unsw.edu.au.|School of Public Health and Community Medicine, UNSW Australia, Sydney, Australia. a.Kelly@unsw.edu.au.
authors.forename: Angela
authors.initials: A
authors.lastname: Kelly-Hanku
authors.affiliation: School of Political and Social Inquiry, Faculty of Arts, Monash University, Melbourne, Australia. andrea.whittaker@monash.edu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Whittaker
mesh_terms: D015746:Abdominal Pain; D000020:Abortifacient Agents, Nonsteroidal; D000024:Abortion, Illegal / Q000009:adverse effects* / Q000523:psychology; D000028:Abortion, Induced / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000379:methods; D000293:Adolescent; D000328:Adult; D005260:Female; D005865:Gestational Age; D006282:Health Personnel; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D008428:Maternal Mortality; D008519:Medicine, Traditional; D016595:Misoprostol; D010219:Papua New Guinea; D028321:Plant Preparations / Q000009:adverse effects; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014592:Uterine Hemorrhage; D016387:Women's Health; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D028321:Plant Preparations; D016595:Misoprostol