A qualitative phenomenological study on consequences of having abortion out of formal healthcare settings: lived experiences of young women who survived induced unsafe abortions in rural areas in Rwanda

Background: Despite substantial effort and legal reforms to improve reproductive health services, unsafe abortion remains a significant public health concern in Rwanda and contributing to maternal morbidity and mortality especially among young women. Objective: This study aimed at exploring the consequences of unsafe abortions among young women in rural Rwanda. Methods: A descriptive phenomenological study was conducted in the Northern Province of Rwanda to explore the consequences of self-induced abortion among young women in rural areas. In-depth interviews were conducted with ten young women, and Colaizzi’s method was used to identify emergent themes. Results: Three themes emerged from the data: (1) Physical and psychological consequences, (2) Socio-economic consequences, and (3) Legal repercussions. Some participants reported severe signs and symptoms, including heavy bleeding and severe pain. Among the psychological problems reported included feelings of shame, post-traumatic stress disorder (PTSD), and suicidal ideation. Participants also reported that they experienced stigma, discrimination, and financial burden as consequences of having abortions out of formal healthcare settings. Legal consequences, such as being taken to court or being jailed due to unsafe abortion, were also reported. Conclusion: The findings in this study suggest that unsafe abortions among young women have several consequences, with significant impacts on their physical psychological health, and socioeconomical well-being. To mitigate these consequences, the Ministry of Health and stakeholders should join efforts to prioritize comprehensive sexual and reproductive health education, improve access to safe and legal abortion services, and actively advocate and work to eliminate stigma and decriminalization associated with seeking or having abortion.