Attitudes of medical students to induced abortion.

Background: Unsafe abortion causes 13% of maternal deaths worldwide. Safe abortion can only be offered under conditions where legislation has been passed for legal termination of unwanted pregnancy. Where such legislation exists, accessibility of safe abortion depends on the attitudes of doctors and other healthcare workers to induced abortion. Medical students as future doctors may have attitudes to abortion that will affect the provision of safe abortion. Little is known about the attitudes of South African medical students to abortion.

Objectives: To assess sexual practices and attitudes of medical students to induced abortion and to determine some of the factors that may influence these attitudes.

Design: A cross-sectional analytic study involving the self-administration of an anonymous questionnaire.

Setting: The questionnaire was administered to medical students at a small, but growing, medical school situated in rural South Africa.

Main Outcome Measures: Demographic data, sexual practices and attitudes to induced abortion.

Results: Two hundred and forty seven out of 300 (82.3%) medical students responded. Their mean age was 21.81 +/- 3.36 (SD) years, and 78.8% were Christians, 17.1% Hindus and 2.6% Muslims. Although 95% of the respondents were single, 68.6% were already sexually experienced, and their mean age at coitarche was 17.24+/-3.14 (SD) years. Although overall 61.2% of the respondents felt abortion is murder either at conception or later, the majority (87.2%) would perform or refer a woman for abortion under certain circumstances. These circumstances, in descending order of frequency, include: threat to mother's life (74.1%), in case of rape (62.3%), the baby is severely malformed (59.5%), threat to mother's mental health (53.8%) and parental incompetence (21.0%). Only 12.5% of respondents would perform or refer for abortion on demand, 12.8% would neither perform nor refer for abortion under any circumstances. Religious affiliation and service attendance significantly influenced some of these attitudes and beliefs.

Conclusion: Although many of the medical students personally felt abortion is murder, the majority are likely to perform or refer patients for abortion under certain circumstances; only about a tenth are likely to perform or refer patients for abortion on demand.