BACKGROUND:
Maternal mortality remains a pressing issue in Indonesia, with an estimated maternal mortality ratio (MMR) of 189 per 100,000 live births. Unsafe abortion contributes significantly to maternal deaths globally, including in Indonesia where access is legally restricted. Provinces in Eastern Indonesia - East Nusa Tenggara, South Sulawesi, and Papua - are underdeveloped regions with limited access to health services, contributing to persistent high MMRs.

OBJECTIVES:
To explore the factors that hinder women’s access to safe abortion and post-abortion care in selected provinces of Eastern Indonesia, particularly among those who meet legal indications such as medical conditions, fetal impairment, or pregnancy due to sexual violence.

METHODS:
This exploratory qualitative study was conducted in three provinces using focus group discussions with women aged 18–45 from diverse districts and geographical contexts. Data triangulation was applied to enhance validity and contextual understanding of sociocultural factors.

RESULTS:
The study revealed multiple intersecting barriers: legal restrictions, stigma, misinformation, limited access to comprehensive abortion and post abortion care, and lack of community awareness. Even women who qualify for legal abortion struggle to access care due to fear of criminalization, social stigma (e.g. “bringing bad luck”), shame, myths (e.g. tribal taboos), and spousal consent requirements. Barriers to post-abortion care include geographic isolation, low trust in healthcare providers, financial constraints, and reliance on traditional healers (paraji/TBA).

CONCLUSIONS:
Women in Eastern Indonesia face substantial sociocultural, legal, and systemic barriers to comprehensive abortion and post-abortion care. These barriers contribute to avoidable morbidity and mortality. Addressing them requires health system strengthening by expand access to primary health care with task sharing to midwives, and culturally sensitive interventions.

KEY MESSAGE:
Empowering women in marginalized regions through legal clarity, community education, and health system reform which optimizing midwives’ involvement is vital to reducing maternal mortality and ensuring access to safe abortion and post-abortion care. Poster session 4 (Group B)