Women's experiences of emergency post-abortion care at Kawempe National Referral Hospital, Uganda: a qualitative descriptive study
- 1Makerere University Faculty of Medicine: Makerere University College of Health Sciences
Abstract
BackgroundPost-abortion care (PAC) encompasses emergency treatment, counselling, contraceptive services, and referral linkages. Emergency post-abortion care (EPAC), the life-saving component of PAC, addresses acute abortion-related complications, including haemorrhage, sepsis, retained products of conception, and severe pain. In Uganda, where abortion is legally restricted and socially stigmatised, womens care experiences are shaped by clinical urgency, fear, moral vulnerability, provider interactions, and structural health system constraints. Despite EPACs centrality to maternal survival, qualitative evidence on how women interpret and evaluate their care experiences in referral hospital settings in Uganda remains limited. This study explored womens experiences of EPAC at Kawempe National Referral Hospital (KNRH) and identified the factors that shaped those experiences.
MethodsA qualitative descriptive design employing inductive thematic analysis was used. Sixteen in-depth interview transcripts from women who received EPAC at KNRH in March- April 2026 were analysed. The Socio-Ecological Model (SEM) was subsequently applied as a post-hoc organising framework to situate findings across individual, interpersonal, facility, and community levels.
ResultsSix themes were identified: (1) survival and physical relief as the immediate measure of good care; (2) pain, fear, and emotional distress during treatment; (3) reassurance and support as buffers against vulnerability; (4) dignity under pressure: communication and privacy in EPAC; (5) structural barriers across the pathway of care; and (6) experiences beyond discharge: incomplete recovery and uncertainty. Care was frequently evaluated through the lens of survival, yet these accounts co-existed with intense procedural pain, compromised privacy, delays, financial burden, and inadequate post-discharge support. EPAC at KNRH was experienced as a complex encounter shaped by bodily vulnerability, interpersonal dynamics, and system-level constraints.
ConclusionsStrengthening EPAC requires patient-centred approaches that integrate clinical effectiveness with respectful communication, pain management, improved triage, and structured post-discharge support.
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BibTeX
@misc{sessimba2026womens,
title = {{Women's experiences of emergency post-abortion care at Kawempe National Referral Hospital, Uganda: a qualitative descriptive study}},
author = {K. Saad Sessimba and A. Godfrey James and B. Andrew and I. Pious and K. Balikudembe and K. Annette and H. Kayiga},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.25.26360981},
url = {https://www.medrxiv.org/content/10.64898/2026.08.25.26360981v2},
note = {CC BY},
}
RIS
TY - UNPB
TI - Women's experiences of emergency post-abortion care at Kawempe National Referral Hospital, Uganda: a qualitative descriptive study
AU - K. Saad Sessimba
AU - A. Godfrey James
AU - B. Andrew
AU - I. Pious
AU - K. Balikudembe
AU - K. Annette
AU - H. Kayiga
PY - 2026
DA - 2026/08/25
PB - medRxiv
DO - 10.64898/2026.08.25.26360981
UR - https://www.medrxiv.org/content/10.64898/2026.08.25.26360981v2
AB - BackgroundPost-abortion care (PAC) encompasses emergency treatment, counselling, contraceptive services, and referral linkages. Emergency post-abortion care (EPAC), the life-saving component of PAC, addresses acute abortion-related complications, including haemorrhage, sepsis, retained products of conception, and severe pain. In Uganda, where abortion is legally restricted and socially stigmatised, womens care experiences are shaped by clinical urgency, fear, moral vulnerability, provider interactions, and structural health system constraints. Despite EPACs centrality to maternal survival, qualitative evidence on how women interpret and evaluate their care experiences in referral hospital settings in Uganda remains limited. This study explored womens experiences of EPAC at Kawempe National Referral Hospital (KNRH) and identified the factors that shaped those experiences. MethodsA qualitative descriptive design employing inductive thematic analysis was used. Sixteen in-depth interview transcripts from women who received EPAC at KNRH in March- April 2026 were analysed. The Socio-Ecological Model (SEM) was subsequently applied as a post-hoc organising framework to situate findings across individual, interpersonal, facility, and community levels. ResultsSix themes were identified: (1) survival and physical relief as the immediate measure of good care; (2) pain, fear, and emotional distress during treatment; (3) reassurance and support as buffers against vulnerability; (4) dignity under pressure: communication and privacy in EPAC; (5) structural barriers across the pathway of care; and (6) experiences beyond discharge: incomplete recovery and uncertainty. Care was frequently evaluated through the lens of survival, yet these accounts co-existed with intense procedural pain, compromised privacy, delays, financial burden, and inadequate post-discharge support. EPAC at KNRH was experienced as a complex encounter shaped by bodily vulnerability, interpersonal dynamics, and system-level constraints. ConclusionsStrengthening EPAC requires patient-centred approaches that integrate clinical effectiveness with respectful communication, pain management, improved triage, and structured post-discharge support.
ER -