Imagine that you are a teen facing an unintended pregnancy. You would hope that when you go to seek advice about having an abortion, the receptionist would smile at you when you enter and tell you not to worry. The doctor would listen attentively to all your questions and whatever you decide, you’d feel supported and able choose what’s best for you and your future. But imagine, instead, that the receptionist barks at you, and the doctor makes a judgmental comment, leaving you frightened and ashamed. It’s clear that provider attitudes can have a huge impact on a young woman’s ability to access reproductive healthcare services, such as abortion and contraception.
That’s one of the reasons why MSI’s program in Ethiopia in partnership with ThinkPlace, launched a study looking into what can prevent teens from accessing reproductive healthcare. In one-on-one conversations with healthcare providers, staff and teens themselves, we found that the attitudes of staff members and providers can play a key role in Ethiopian teens’ ability to access contraception and safe abortions.
In Ethiopia, abortion is still heavily stigmatized, making it harder for women to get the care they need. Unfortunately, even medical providers can perpetrate abortion stigma. When researchers talked to government healthcare providers, they found they can have their own, unnecessary requirements for teens to “qualify” for an abortion, imposing their own judgments upon teens trying to make a personal decision. One government provider required that adolescents be unmarried to access abortion services. Another said that sexual assault survivors should bring in a parent if they wanted to receive an abortion. These arbitrary and unfair requirements prevent teens from accessing life-changing abortion services.
Fortunately, we also heard from MSI providers and staff members who actively fight abortion stigma — and they make a huge difference for teens trying to access a safe abortion. Leadership has a big impact on staff members’ attitudes. If leaders, like our MSI clinical, country and regional directors, support adolescent access to contraceptives and abortion care, then providers and other staff members are motivated to do the same.
Interestingly, non-clinical staff members can also play a role in supporting teen access to abortion care. The young people we spoke to responded positively to informal interactions with staff. For these teens, walking into the clinic and interacting with a friendly receptionist made them feel welcome and supported in their decision. Even the most unlikely staff members can become advocates for access to contraceptives and safe abortions. After the daughter of a private clinic’s security guard had an abortion, the guard became an ally in the fight against abortion stigma himself.
“The security guard’s daughter came for safe abortion services when he was off duty. When the guard learned that the girl had taken the service, he started supporting safe abortion and now even refers clients to the clinic.” — Blue Star clinic owner
From the security guard to the medical provider, our team members in Ethiopia are tirelessly working to empower young women with access to life-changing abortion services and contraceptives. We hope that this study sheds light on how services can work to create a safe and welcoming environment for teens, so that they too can take control of their futures.