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The era of using online coupons is here, and it's only going to get better. We've created this great website to help you save on nearly everything you buy online. To get a jump start on your savings Where is Sector 6? Few things put you in the mood for adventure more than researching your next dream destination. So, are you ready to learn a little more about Sector 6? The neighborhood sits 4 miles west of downtown Bucharest, the nation's marvelous capital. There are around 1,, locals that live in Bucharest.

I took my 12 and 13 year old niece and nephew who are Sector 6 vets and we all had such a fun time together. I don't think I stopped smiling and laughing the entire time. The proportion of later term abortions performed in South Africa is relatively high, which has important implications for safety given that most mortality and morbidity from unsafe procedures happens in later gestational age abortions [ 1 , 10 , 11 ]. We also know very little about the mechanisms through which women learn about informal sector abortion services in South Africa. Studies have shown that women in diverse contexts rely on friends and community members for information about abortion [ 14 , 15 , 16 ], and that women with strong social networks have more success in overcoming logistical barriers to accessing care [ 17 ].

Three methods are commonly used to reach hidden populations, such as women who have attempted informal sector abortion [ 18 ]. Then, we employed the recruitment techniques, but not the analysis methods, from a specific variation of snowball sampling called respondent driven sampling RDS [ 18 ]. RDS differs from snowball sampling in that it enables researchers to make unbiased estimates from chain-referral sampling by weighting participants by the size of their social network during the analysis phase [ 22 ].

Once a participant with a valid coupon presents to the study site, she is provided with the same number of coupons with which to enroll other members of the social network, thus resulting in a lengthy chain of participants representing the target population [ 18 , 23 ]. Four elements differentiate the RDS recruitment process from the typical snow ball sampling approach: 1 use of a coupon system to document recruitment chains; 2 rationed recruitment with a specific allotment of coupons per seed; 3 collection of information on personal network size; and 4 pre-existing relationships between recruiters and recruits within recruitment chains [ 24 ].

Several potential seeds were identified who maintained close connections with women who had experienced informal sector abortion in South Africa. The seed distributed six recruitment coupons to women they knew. Those women who redeemed their coupon and completed the survey received six additional coupons to distribute to their respective contacts who also had experience with informal sector abortion.

Each coupon had a unique identifier and included contact information for the research staff and recruits were instructed to call the phone number on the coupon to learn more about the study.

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Study staff, including KD and MM, provided preliminary information about the study by phone and scheduled a time to meet in person to conduct the survey. Recruits were screened for eligibility at the interview. Eligibility criteria included being age 18—50, able to speak English, and having attempted an informal abortion in the last 5 years. If participants had a valid coupon i. Because of the recruitment coupon techniques that we employed, and restrictions on time and budget for the project, active recruitment for the study stopped once the 16th participant was enrolled—a stopping point which could have yielded a maximum potential 96 participants.

The survey aimed to collect information on three areas of interest: 1 Information seeking behavior around obtaining informal sector abortion, 2 Existence and composition of social networks for information needs about informal sector abortion, 3 Safe abortion information and access needs of peers, close female friends, partners, and family.

Survey data were described with descriptive statistics, using Stata 13 College Station, Texas. Two sets of incentives were provided to participants: participants received the first incentive ZAR when they completed the survey with a valid coupon and they received an additional incentive ZAR50 for each participant they subsequently recruited in to the study; recruiters were linked to their recruits by the identification numbers on their respective coupons. Women who were not eligible received a nominal amount ZAR20 to cover travel expenses.

The study recruitment and interviews took place in March and April of A total of 96 coupons were distributed. Consequently, 67 women presented for screening and 43 women enrolled in the survey. One participant was later excluded from the sample of 43 because the research team was unconvinced by her recount of events, and one participant was maintained in the sample despite not having followed through with the informal sector abortion that she had sought —leaving 42 total participants Fig.

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At the conclusion of data collection, 29 recruitment coupons were still in circulation. One additional recruit contacted the study staff to set up an interview, but did not attend the appointment and was unreachable by phone. Recruitment Flow. Filled in circles are participants who completed the survey. The seed blue recruits wave 1 participants red , which recruit wave 2 participants purple , and so on. All participants had been pregnant prior to the study mean 3.

On average, women had two children each SD 1.

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Ninety percent of women knew others in their family or community who had experiences with informal sector abortion. On average, women knew 3. Logistical reasons also played a role for why women sought care in the informal sector, including timeliness of services 5 women , lack of knowledge of where to seek legal services, and cost. About one-fifth of participants were 12 or more weeks in the pregnancy Table 4. One woman had an infection following her informal sector abortion and received antibiotics at a public health facility.

When their attempts failed, five women sought additional treatment to end their pregnancies from a different informal provider, public facilities, and a traditional healer. The majority of participants consumed home remedies made of substances they bought from the chemist or a local shop Table 5.

One woman did not ultimately have an informal sector abortion and therefore did not report an abortion method type. One of the 13 women who ingested herbal mixtures from a traditional healer was given instructions to boil abrasive substances mixed with newspaper. Seven women who bought tablets from unregistered providers described the tablets as varying in shape, size and color. The number of tablets provided to women ranged from two to six and were presumably a combination of misoprostol and pain medication, based on the visual descriptions women provided.

None of the women in the sample reported using instrumentation to induce abortion. Some women in our study did not know where or how to seek abortion services within the formal health system, and two women believed the cost would be lower outside the formal health system—despite the fact that public sector facilities are required to offer services for free.

That thirty-percent of women in our study cited seeking an informal sector abortion because of concerns about privacy, mistreatment and stigma from providers is a striking commentary on the perceptions of quality of abortion care in the formal sector. In a sample population consisting of many sex workers, mistrust of the formal health care system is not unexpected; sex workers seeking abortion in Cape Town likely face a double stigmatization related to abortion and their work.

For this reason, this is a sub-population which is often overlooked and under-represented in studies about abortion. Our data suggest that at least some women are bypassing formal sector services entirely because of concerns over provider attitudes and service provision.

The widespread use of herbs and home remedies is somewhat surprising given current thinking with respect to the role of misoprostol in increasing access to safe abortion in restrictive settings [ 25 , 26 ]. The use of unproven and potentially less safe substances to induce abortion at home is, however, consistent with data from the United States where women also cited barriers to accessing formal sector services and concerns over quality of care at abortion clinics for seeking abortion outside of a clinic setting [ 27 ].

The rate of potential warning signs of complications reported was high; more than a quarter of the sample reported seeking additional care for heavy bleeding. The similarity across findings from the United States and South Africa, two settings where legal grounds for abortion are broad but where multiple barriers to access exist, may suggest that the role of misoprostol in increasing access to safe abortion is moderated by legal settings.

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Perhaps, where abortion is illegal, regulations on pharmacy access to misoprostol are less strict and black market availability of medications for abortion is enabled, and where abortion is legal but difficult to access, medications for abortion may be more highly regulated leaving women with fewer options for safe informal sector abortion. More research is needed to better understand the role that abortion medications play in increasing access to safe abortion in diverse legal settings.

Our study does have some important limitations to consider. The data do not provide generalizable results about informal sector abortion and related morbidity and mortality outcomes, due to the fact that the sample size is relatively small and the study population comprised mostly female sex workers.

It is possible that a largely sex worker sample is more socially networked than the larger population of women attempting informal sector abortion. We also note that seeking an informal sector abortion differs from other behaviors studied through snowball sampling techniques in that, unlike men having sex with men or injection drug use, abortion is not typically an ongoing or recurring behavior.


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However, in spite of this distinction, it does seem that snowball sampling and specifically RDS recruitment strategies are able to identify women who engage in the stigmatized behavior of seeking informal sector abortion. Finally, though we did successfully employ RDS recruitment strategies i. Our decision to compensate with a slightly higher number of coupons per recruiter than is typical for RDS recruitment [ 24 ] could have influenced recruiters to suggest participation to those who were in-eligible and contributed to the high rate of ineligibility among coupon holders.

Some individual stories came across as scripted or pre-prepared.