Barriers to access legal abortion after 13 weeks' gestation: a qualitative study with health professionals in selected cities of Argentina

Law 27.610 establishes access to abortion up to 14 weeks gestation (WG) at the woman's request, and without a limit regarding specific situations. The law does not substantially modify access to abortion after 14 WG compared to what was legally possible before this new law. However, it presents an opportune context to improve access and quality of care for these abortions which face a series of additional barriers. We aim to explore and analyze the conditions that influence access and care for abortion after 13 WG, in order to identify barriers and suggest strategies. We conducted 14 in-depth interviews with public health system providers in selected cities of Argentina, who provided access to abortion after 13 WG. We identified as main barriers: 1) public policies barriers: lack of clarity and support from public policies, advanced gestational age legal framework, conscientious objection absence of regulation; 2) institutional barriers: lack of institutional support, lack of training in medical careers, overload of tasks for those who provide access, denial of abortion services, geographical access barriers to the few institutions that provide care; and 3) subjective and interpersonal barriers: emotional burden for providers in advanced WG; providers stigmatization and isolation; people seeking abortion's shame and fear of being mistreated and reported.