The Georgian law enables legal abortion up to 12 weeks of gestation, yet Georgian women continue to face significant challenges in terms of availability and accessibility of safe abortion information and services, especially those living in rural areas. To analyse the situation Association HERA XXI, ASTRA member from Tbilisi, pursued a qualitative study of the existing barriers to the availability of abortion in 7 regions of Georgia.

The survey aimed to identify the barriers to safe abortion services using the technique of in-depth interviewing and real life experiences. It covered the experiences of respondents in the context of induced abortions over the past decade.

The results of the survey helped identify the following barriers to accessibility to safe abortion services in Georgia:

• Barriers regarding geographical availability – especially faced by women living in rural areas far from a regional center and/or women living in the mountainous regions of the country. This barrier is closely associated with economic factors;
• Lack of financial affordability of abortion services – because of the high costs of abortion services women often have to borrow funds from a bank or resort to illegal abortion.
• Lack of psychological support – main negative experience women speak out about is the lack of psychological support from family, society as well as lack of psychological and support interventions in medical institutions.
• Pre-abortion counselling service gaps – majority of the women participating in the survey had not undergone appropriate pre abortion counseling.
• Biased Counseling in a non-confidential environment and widespread conscientious objection among medical doctors – Research reveals widely usage of conscientious objection by medical doctors and not referring patients to alternative doctor or service providers. Doctors attempt to dissuade patients from undergoing abortion.
• The five-day mandatory waiting period is considered inefficient by many women participating in the survey, based on the argument that women make decision to have an abortion after considering too many factors and do not easily change their decisions. Delays in the provision of the abortion service: a) put a strain on the psychological state of women; b) create additional logistical barriers for women living in rural areas far from a regional centre and/or women living in the mountainous regions of the country.
• Gaps in post-abortion care – as in the case of a pre-abortion counselling service, patients are not fully informed about the components of post-abortion care, modern contraceptive methods and in most cases the service remains completely unavailable.
• Lack of information – Low level of awareness of issues concerning family planning and reproductive and sexual health among the respondents is noticeable: part of the respondents had never heard of contraception and some associate contraception only woth medicines. The level of awareness of emergency contraception among the respondents is even lower.

Women in need for abortion services in Georgia encounter accessibility and availability barriers that strongly impede the quality of the serives and wellbeing of women. Limited number of abortion providers, service and travel expenses, biased counseling in a non-confidential environment, weak referral mechanism lead to unsafe and/or self-induced abortions and negatively influence women’s health.

Source: HERA XXI