Many women in Cambodia remain unaware that abortion is legal, pushing them into pursuing cheap and unsafe practices, according to a new study that also found some medical professionals held the same false belief.

Published in the journal Global Public Health, the study, Abortion politics in Cambodia: Social history, local forms and transnational issues said widespread religious beliefs contributed to the idea abortions were wrong.

“Contraceptive prevalence remains quite low in Cambodia and various studies document that abortive practices use may be among the highest in South East Asia,” author Pascale Hancart-Petitet wrote in an email. “The main issue is that many women think that it is illegal.”

Despite abortion being legal since 1997, caregivers were often not aware of the legal specifics, it said. “In fact, I don’t know whether abortion service is illegal or not,” the study quotes a midwife at an NGO as saying.

“Normally in the public hospital if . . . you have a disease that can’t let you keep the baby, then the hospital staff will perform an abortion to save your life,” the midwife said. “On the contrary if you’re healthy and you go to the public hospital to seek an abortion, then they won’t do it for you.”

During the yearslong study, Hancart-Petitet found many women induced their own abortions or sought unsafe ones despite a plethora of contraceptive options.

“The process of searching for and obtaining high-quality abortion care was unnecessarily complicated and costly for women and families in urban areas,” Hancart-Petitet wrote, with surgical abortions in public institutions costing up to $30, and private clinics charging up to $150. That compares to as little as $5 by an untrained provider, where corroded scissors and clamps were common and the same kit was often re-used.

Further, the idea of “taking a life” could lead Buddhists to shun the practice – though some women interviewed said “the bad sin would fall on the abortion provider herself, as ‘She takes many lives for money’.”

Gender academic Kasumi Nakagawa said from her own research the reason that many women in Cambodia decided not to have abortions when they had unwanted pregnancies came down to their religious beliefs and patriarchic social norms.

“Patriarchal society in Cambodia also regards women’s main role as to ‘reproduce’, thereby abortion is contrary to male-dominated society’s morality,” she said.