"We can lose our life for the abortion": exploring the dynamics shaping abortion care in peri-urban Yangon, Myanmar.
OBJECTIVE
Induced abortion in Myanmar is severely legally restricted and permissible only to save a woman's life. As a result, unsafe abortion is common and contributes significantly to maternal mortality. Our overall study aimed to explore women's reproductive health needs in peri-urban Yangon, a dynamic series of townships on the periphery of the country's largest city characterized by poor infrastructure, slum settlements and a mobile, migrant population. In this paper, we focus specifically on the perceptions, opinions and experiences of both adult women and key informants with respect to induced abortion and postabortion care in peri-urban Yangon.


METHODS
In 2014, we conducted 18 key informant interviews with individuals working in reproductive health in peri-urban Yangon and seven focus group discussions with health service providers (n=2) and adult women (n=5). We analyzed these data for content and themes using a multiphased iterative approach.


RESULTS
In peri-urban Yangon, unsafe abortion appears to be common and is largely provided by traditional birth attendants. Women use a range of mechanical, medication and traditional methods, often in combination. Postabortion care is available but misinformation and fear of harassment keep many women from accessing timely care.


CONCLUSIONS
Efforts to reform the highly restrictive abortion law in Myanmar combined with implementation of harm reduction strategies have the potential to greatly improve a neglected area of women's health. Future research on the cost of unsafe abortion to the public sector could be instrumental in achieving legal and service delivery reform.


CONCLUSIONS
Measures to increase access to safe, legal abortion care and reduce harm from unsafe abortion need to be expanded. Developing strategies to liberalize Myanmar's abortion law, raising awareness about misoprostol, training clinicians to provide woman-centered postabortion care and documenting the cost of unsafe abortion to the public sector appear warranted.
Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
Grace
G
Sheehy
National Young Women's Christian Association of Myanmar, No. 119, Bogalayzay Street, Botataung Township, Yangon, Myanmar.
Yadanar
Y
Aung
Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; Cambridge Reproductive Health Consultants, 1770 Massachusetts Avenue, Suite 181, Cambridge, MA 02140, USA. Electronic address: angel.foster@uottawa.ca.
Angel M
AM
Foster
D000028:Abortion, Induced / Q000331:legislation & jurisprudence / Q000379:methods / Q000523:psychology*; D000328:Adult; D000359:Aftercare / Q000379:methods / Q000523:psychology*; D005239:Fear; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008427:Maternal Health Services; D008880:Midwifery; D002052:Myanmar; D011247:Pregnancy; D036301:Qualitative Research
Burma; Misoprostol; Postabortion care; Reproductive health