The availability of abortion at state hospitals in Turkey: A national study

Abstract

Introduction: Abortion in Turkey has been legal since 1983 and remains so today. Despite this in 2012 the Prime Minister declared that in his opinion abortion was murder. Since then there has been growing evidence that abortion access particularly in state hospitals is being restricted although no new legislation has been offered. Objectives: The study aimed to determine the number of state hospitals in Turkey that provide abortions. Study design: The study employed a telephone survey in 2015-2016 where 431 state hospitals were contacted and asked a set of questions by a mystery patient. If possible information was obtained directly from the obstetrics/gynecology department. I removed specialist hospitals from the data set and the remaining data were analyzed for frequency and cross-tabulations were performed. Results: Only 7.8% of state hospitals provide abortion services without regard to reason which is provided for by the current law while 78% provide abortions when there is a medical necessity. Of the 58 teaching and research hospitals in Turkey 9 (15.5%) provide abortion care without restriction to reason 38 (65.5%) will do the procedure if there is a medical necessity and 11 (11.4%) of these hospitals refuse to provide abortion services under any circumstances. There are two regions encompassing 1.5 million women of childbearing age where no state hospital provides for abortion without restriction as to reason. Conclusion: The vast majority of state hospitals only provide abortions in the narrow context of a medical necessity and thus are not implementing the law to its full extent. It is clear that although no new legislation restricting abortion has been enacted state hospitals are reducing the provision of abortion services without restriction as to reason. Implications: This is the only nationwide study to focus on abortion provision at state hospitals. (C) 2017 Elsevier Inc. All rights reserved.