Attitudes and intentions regarding abortion provision among medical school students in South Africa

Context: Although South Africa liberalized its abortion law in 1996, significant barriers still impede service provision, including the lack of trained and willing providers. A better understanding is needed of medical students' attitudes, beliefs and intentions regarding abortion provision. Methods: Surveys about abortion attitudes, beliefs and practice intentions were conducted in 2005 and 2007 among 1,308 medical school students attending the University of Cape Town and Walter Sisulu University in South Africa. Bivariate and multivariate analyses identified associations between students' characteristics and their general and conditional support for abortion provision, as well as their intention to act according to personal attitudes and beliefs. Results: Seventy percent of medical students believed that women should have the right to decide whether to have an abortion, and large majorities thought that abortion should be legal in a variety of medical circumstances. Nearly one-quarter of students intended to perform abortions once they were qualified, and 72% said that conscientiously objecting clinicians should be required to refer women for such services. However, one-fifth of students believed that abortion should not be allowed for any reason. Advanced medical students were more likely than others to support abortion provision. In multivariate analyses, year in medical school, race or ethnicity, religious affiliation, relationship status and sexual experience were associated with attitudes, beliefs and intentions regarding provision. Conclusions: Academic medical institutions must ensure that students understand their responsibilities with respect to abortion care-regardless of their personal views-and must provide appropriate abortion training to those who are willing to offer these services in the future.