Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India*
This qualitative study explored provider perspectives on self-managed abortion (SMA) in India, their roles, and how they share information about pathways to both clinician- and self-managed abortion care. We conducted 33 semi-structured interviews with a range of providers (medical, community health...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Sexual and Reproductive Health Matters |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/26410397.2025.2531680 |
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| author | Laura E. Jacobson Caila Brander Balasubramanian Palanisamy Sruthi Chandrasekaran Blair G. Darney Julia M. Goodman Ruvani Jayaweera Caitlin Gerdts |
| author_facet | Laura E. Jacobson Caila Brander Balasubramanian Palanisamy Sruthi Chandrasekaran Blair G. Darney Julia M. Goodman Ruvani Jayaweera Caitlin Gerdts |
| author_sort | Laura E. Jacobson |
| collection | DOAJ |
| description | This qualitative study explored provider perspectives on self-managed abortion (SMA) in India, their roles, and how they share information about pathways to both clinician- and self-managed abortion care. We conducted 33 semi-structured interviews with a range of providers (medical, community health, and pharmacy) in three states in India: Jharkhand, Bihar, and Tamil Nadu. Using thematic analysis, we examined provider perspectives on SMA, their involvement in abortion care, and how they contribute to information sharing around access pathways. We categorised findings by provider type, direction of care pathways, abortion modality (clinician-managed vs. SMA), and the kind of care delivered. Our findings showed most providers described abortion as conditionally acceptable and primarily encouraged clinician-managed care. Concerns about SMA safety and potential liability often led them to discourage SMA. Nonetheless, participants acknowledged three areas where providers played a role in SMA: providing information, dispensing medication, and providing support (i.e. managing pain). Pharmacy workers and local providers shared information with abortion seekers on pathways to access SMA care. Some community health workers directed clients to pharmacies, but more often only provided SMA information and support. Despite provider concerns, support for and pathways to SMA exist in India. Understanding the dynamics of provider perspectives and roles can inform improvements to comprehensive reproductive health policies and programmes in order to promote person-centred abortion care – including SMA – and address provider concerns. Synergies are needed between the formal health sector and SMA support networks to advance person experiences and reinforce quality abortion care as a human right. |
| format | Article |
| id | doaj-art-d56bd08ce7784aeaa2c565f97964ea46 |
| institution | Kabale University |
| issn | 2641-0397 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Sexual and Reproductive Health Matters |
| spelling | doaj-art-d56bd08ce7784aeaa2c565f97964ea462025-08-20T03:36:26ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972025-12-0133110.1080/26410397.2025.2531680Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India*Laura E. Jacobson0Caila Brander1Balasubramanian Palanisamy2Sruthi Chandrasekaran3Blair G. Darney4Julia M. Goodman5Ruvani Jayaweera6Caitlin Gerdts7Assistant Professor, Portland State University, OHSU-PSU School of Public Health, Portland, OR, USA; Independent Consultant, Ibis Reproductive Health, Oakland, CA, USA.Senior Research Manager, Ibis Reproductive Health, Oakland, CA, USAExecutive Director, Rural Women’s Social Education Centers (RUWSEC), Tamil Nadu, IndiaIndependent Consultant, Ibis Reproductive Health, Oakland, CA, USAAssociate Professor, OHSU-PSU School of Public Health, Portland, OR, USA; Associate Professor, Oregon Health and Science University, Portland, OR, USA; Affiliate Professor, Instituto Nacional de Salud Publica (INSP), Centro de Investigacion en Salud Poblacional (CISP), Cuernavaca, MexicoAssociate Professor, OHSU-PSU School of Public Health, Portland, OR, USASenior Research Scientist, Ibis Reproductive Health, Oakland, CA, USAVice President of Research, Ibis Reproductive Health, Oakland, CA, USAThis qualitative study explored provider perspectives on self-managed abortion (SMA) in India, their roles, and how they share information about pathways to both clinician- and self-managed abortion care. We conducted 33 semi-structured interviews with a range of providers (medical, community health, and pharmacy) in three states in India: Jharkhand, Bihar, and Tamil Nadu. Using thematic analysis, we examined provider perspectives on SMA, their involvement in abortion care, and how they contribute to information sharing around access pathways. We categorised findings by provider type, direction of care pathways, abortion modality (clinician-managed vs. SMA), and the kind of care delivered. Our findings showed most providers described abortion as conditionally acceptable and primarily encouraged clinician-managed care. Concerns about SMA safety and potential liability often led them to discourage SMA. Nonetheless, participants acknowledged three areas where providers played a role in SMA: providing information, dispensing medication, and providing support (i.e. managing pain). Pharmacy workers and local providers shared information with abortion seekers on pathways to access SMA care. Some community health workers directed clients to pharmacies, but more often only provided SMA information and support. Despite provider concerns, support for and pathways to SMA exist in India. Understanding the dynamics of provider perspectives and roles can inform improvements to comprehensive reproductive health policies and programmes in order to promote person-centred abortion care – including SMA – and address provider concerns. Synergies are needed between the formal health sector and SMA support networks to advance person experiences and reinforce quality abortion care as a human right.https://www.tandfonline.com/doi/10.1080/26410397.2025.2531680abortionself-managed abortionpharmacyquality of careIndia |
| spellingShingle | Laura E. Jacobson Caila Brander Balasubramanian Palanisamy Sruthi Chandrasekaran Blair G. Darney Julia M. Goodman Ruvani Jayaweera Caitlin Gerdts Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* Sexual and Reproductive Health Matters abortion self-managed abortion pharmacy quality of care India |
| title | Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* |
| title_full | Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* |
| title_fullStr | Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* |
| title_full_unstemmed | Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* |
| title_short | Supporting self-managed abortion care in “practice not premise”: a qualitative study of provider perspectives, roles, and information pathways to care in India* |
| title_sort | supporting self managed abortion care in practice not premise a qualitative study of provider perspectives roles and information pathways to care in india |
| topic | abortion self-managed abortion pharmacy quality of care India |
| url | https://www.tandfonline.com/doi/10.1080/26410397.2025.2531680 |
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