title: Abortion experiences among Zanzibari women: a chain-referral sampling study.
abstract: BACKGROUND
  In Zanzibar, a semi-autonomous region of Tanzania, induced abortion is illegal but common, and fewer than 12% of married reproductive-aged women use modern contraception. As part of a multi-method study about contraception and consequences of unwanted pregnancies, the objective of this study was to understand the experiences of Zanzibari women who terminated pregnancies.
  
  
  METHODS
  The cross-sectional study was set in Zanzibar, Tanzania. Participants were a community-based sample of women who had terminated pregnancies. We carried out semi-structured interviews with 45 women recruited via chain-referral sampling. We report the characteristics of women who have had abortions, the reasons they had abortions, and the methods used to terminate their pregnancies.
  
  
  RESULTS
  Women in Zanzibar terminate pregnancies that are unwanted for a range of reasons, at various points in their reproductive lives, and using multiple methods. While clinical methods were most effective, nearly half of our participants successfully terminated a pregnancy using non-clinical methods and very few had complications requiring post abortion care (PAC).
  
  
  CONCLUSIONS
  Even in settings where abortion is illegal, some women experience illegal abortions without adverse health consequences, what we might call 'safer' unsafe abortions; these kinds of abortion experiences can be missed in studies about abortion conducted among women seeking PAC in hospitals.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA. norris.570@osu.edu.|Present address: College of Public Health, The Ohio State University, 326 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210-1351, USA. norris.570@osu.edu.
authors.forename: Alison
authors.initials: A
authors.lastname: Norris
authors.affiliation: Yale College Charles P. Howland Fellow, 74 High Street, New Haven, CT, 06511, USA.|Present address: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall CB#7435, Chapel Hill, NC, 27599, USA.
authors.forename: Bryna J
authors.initials: BJ
authors.lastname: Harrington
authors.affiliation: Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.|Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.affiliation: African Union Commission, Department of Medical Services, Addis Ababa, Ethiopia.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hemed
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Hindin
mesh_terms: D000024:Abortion, Illegal / Q000009:adverse effects* / Q000208:ethnology; D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D003268:Contraception Behavior / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008425:Maternal Behavior / Q000208:ethnology; D008875:Middle Aged; D010298:Parity; D011183:Postoperative Complications / Q000453:epidemiology / Q000208:ethnology; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000208:ethnology; D043762:Reproductive Behavior / Q000208:ethnology; D057566:Self Report; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: Abortion; Chain-referral sampling; Post abortion care; Pregnancy; Reproductive health; Zanzibar