title: Abortion services at hospitals in Istanbul.
abstract: OBJECTIVE
  Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications.
  
  
  METHODS
  Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted.
  
  
  RESULTS
  14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances.
  
  
  CONCLUSIONS
  State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.
authors.affiliation: a Gender and Women's Studies Research Center, Kadir Has University , Istanbul , Turkey.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: O'Neil
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000029:Abortion, Legal / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D011247:Pregnancy; D034121:Reproductive Health Services / Q000706:statistics & numerical data; D014421:Turkey
keywords: Abortion services; Istanbul; availability; private hospitals; state hospitals