Experiences and opinions of healthcare providers on legal abortion in Mexico City

Background: In April 2007, the Mexico City legislature legalized first trimester abortions in the Federal District. The procedure is offered in 14 public hospitals of the local Ministry of Health (MOH). Thousands of women from the Federal District and other states have been treated since. We have nearly completed a rigorous qualitative study among a diverse group of healthcare providers affiliated with these MOH hospitals to document their service provision experiences and opinions post legal reform.

Methods: We expect to complete about 25 semi-structured interviews with gynecologists, nurses and social workers of the 14 hospitals that offer abortion services. We are also conducting participant observation of hospital intake services. The data will be transcribed, coded and analyzed using the software Atlas-ti.

Results: Preliminary analysis to date (of 13 interviews across 6 hospitals) indicates that the respondents perceived a serious lack of preparation among hospital personnel in response to the legal reform; however, with time, respondents agree that conditions have improved greatly. Moreover, the hostile attitude of hospital personnel not involved in legal abortion service provision has created a tense work environment with few social support networks. Although many respondents agreed with the possibility conscientious objection, they felt that too many of their peers “took the easy road out” and denied performing abortions based on this right. The number of abortions per hospital is around 10 procedures daily. Basic counseling was provided in all hospitals.

Conclusion: Despite the many challenges, the legal abortion program is functioning, with no post-abortion complications.