Lived experience of unsafe abortion among commercial sex workers in Gedeo Zone, Southern Ethiopia: A phenomenological qualitative study

Introduction: Unsafe abortion is a significant cause of maternal morbidity and mortality in low- and middle-income countries. Female sex workers in Ethiopia are exposed to unwanted and unplanned pregnancy and subsequent abortion. In the absence of access to quality abortion care services, the chances of experiencing unsafe abortion are high. However, limited evidence is available on female sex workers’ experience with abortion services and their exposure to unsafe abortion. Objective: To explore the lived experiences of female sex workers who underwent unsafe abortion in Gedeo Zone, Southern Ethiopia. Methods: The study was conducted among female sex workers in Gedeo Zone, Southern Ethiopia, from April to June 2024. The study was employed among female sex workers who had a history of unsafe abortion in the past 2 years. Both establishment-based and street-based female sex workers were selected using the snowball sampling method. Face-to-face in-depth interviews were conducted with participants in locations of their preference to ensure privacy. Data saturation was achieved after interviewing 18 participants. The collected data were transcribed verbatim, translated into English, and analyzed thematically using the Open Code 4.03 software. Trustworthiness was ensured throughout the data analysis process. Design: A qualitative study with a phenomenological design was employed. Results: The findings of this study revealed that poor knowledge of safe abortion services and poor socioeconomic status are the main causes for seeking unsafe abortion services by commercial sex workers. Unsafe pregnancy terminations were mainly experienced using commercial medications from private pharmacies and using traditional practices through herbal and mechanical techniques. Sex workers resorted to traditional methods and self-induced medication abortions, leading to adverse health, psychosocial, and economic consequences. Conclusion: The study highlights the poor information literacy and limited access to abortion services for sex workers, leading to unsafe practices and subsequent physical and psychological suffering. Therefore, stakeholders should collaborate to increase female sex workers’ knowledge and access to safe abortion services.