While the incidence of self‐managed abortion (SMA) in India is well‐documented, why the majority of abortions in India are self‐managed remains largely unanswered. This qualitative study explores factors that contribute to decision‐making about SMA in India. Between January and August 2022, we conducted 43 in‐depth interviews with people who self‐managed abortions across six Indian states, recruiting via accredited social health activists, clinic sampling frames, and social media posts. Underpinned by the Coast et al. framework, we coded and analyzed transcripts using thematic analysis and then organized factors that contributed to people's decision‐making around SMA versus facility‐based care. Contributing factors to people's decisions not to seek facility‐based abortion care included concerns about poor treatment by providers, the unaffordability of private facility care, and fear of procedural abortion methods. Factors contributing to people's decision to seek SMA included having prior SMA experience, access to information about SMA, affordability, privacy, accessibility, and convenience. SMA is a valued option for abortion seekers in India due to perceived benefits and a desire to avoid facility‐based care. Our findings highlight the need for improved person‐centered abortion care at facilities and offer potential avenues for developing supportive resources for people who self‐manage abortion in India.

中文翻译：

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“我从心底里相信这些药物会没事”：印度自我管理堕胎轨迹决策的定性分析


虽然印度自我管理流产 （SMA） 的发生率有据可查，但为什么印度的大多数流产是自我管理的，在很大程度上仍未得到解答。这项定性研究探讨了有助于印度 SMA 决策的因素。2022 年 1 月至 8 月期间，我们对印度 6 个邦的自我管理堕胎者进行了 43 次深入访谈，通过经认证的社会健康活动家、诊所抽样框架和社交媒体帖子进行招募。在 Coast 等人框架的基础上，我们使用主题分析对转录本进行编码和分析，然后组织有助于人们围绕 SMA 与基于设施的护理做出决策的因素。人们决定不寻求基于设施的堕胎护理的促成因素包括对提供者治疗不佳的担忧、私人设施护理的负担能力以及对程序性流产方法的恐惧。导致人们决定寻求 SMA 的因素包括先前的 SMA 经验、获取有关 SMA 的信息、负担能力、隐私、可访问性和便利性。SMA 是印度寻求堕胎者的重要选择，因为它被认为有好处并且希望避免基于设施的护理。我们的研究结果强调了在设施中改进以人为本的堕胎护理的必要性，并为为印度自我管理堕胎的人开发支持资源提供了潜在途径。