Hidden realities: What women do when they want to terminate an unwanted pregnancy in Bolivia.

OBJECTIVE To explore women's experience of unwanted pregnancy and induced abortion in Bolivia, where nearly all induced abortions are carried out in clandestine, unregulated, and unsafe conditions. METHODS Qualitative and quantitative research methods, including focus group discussions, in-depth interviews and a structured survey of women of reproductive age, were used to explore the experience of unwanted pregnancy and induced abortion in poor urban areas of 5 Bolivian cities. RESULTS Of the 1175 sexually experienced women surveyed, 13% reported having had an induced abortion. The methods they tried included surgical abortion, taking misoprostol, drinking herbal and chemical preparations, and inflicting physical trauma on themselves. Many women made multiple attempts before successfully terminating a pregnancy. Lack of knowledge and confusion about how to use misoprostol may have contributed to the complications that resulted in seeking postabortion care. CONCLUSION Increased access to accurate information and counseling about abortion options are paramount if women are to make informed decisions and minimize health risks.