Stigma and Its Associated Factors, Experiences and Coping Strategies of Induced Abortion Among Reproductive-age Women Attending Maternal and Child Health Clinics in Gedeo Zone, Southern Ethiopia: A Mixed-methods Study

Background: A voluntary decision to end an undesired, premature, or unplanned pregnancy is known as an abortion. Individual-Level Abortion Stigma is a negative attitude, belief or internalized feeling experienced by a woman due to having undergone an induced abortion. It is the personal, internal experience of stigma-not just how they treat them, but how they feel about themselves. Following an induced abortion, women experience vast number of problems and begin to adopt new coping mechanisms to adjust to their new circumstances. Methods: This study is conducted among women in reproductive age attending maternal and child health clinics in Gedeo zone governmental hospitals. The quantitative sample included were 408 women selected through systemic random sampling while fro qualitative 13 women who were include where data saturation occurred and they were purposely chosen. Quantitative data was analysed with SPSS software and descriptive and logistics regressions were used. The qualitative data was transcribed, translated, coded and thematically analysed using Atlas ti software. Ethical approval was obtained from Dilla University. Informed consent was obtained from all the participants and confidentiality was maintained. Result: Almost half of the women (45.6%) experienced high individual level abortion stigma (ILAS). Younger age, higher education, self-blame and perceived negative community attitudes, having unsupportive partner, disclosing to nobody, coping by spiritual activities and disrespect or judgemental treatrments were found as significant predictors. The qualitative part focused on physical symptoms, psychological distress, spiritual conflict and social challenges. The key protective factors were supportive social circle, spiritual coping and respectful healthcare interaction while in contrast disrespectful provider behaviour and limited psychological support exacerbated stigma. After post abortion, most women felt relief but persistent guilt and moral conflict was observed. Conclusions: Nearly half of women experienced high-internalized abortion stigma, influenced by age, education, self-blame, and negative community attitudes, and expressed through physical, psychological, spiritual, and social challenges.