This research report on second-trimester abortion in Ethiopia—which has one of the highest maternal mortality rates in the world—explores the factors causing women to delay abortion care until the second trimester, thereby facing greater risks of medical complications. The research entailed interviews with more than two dozen women about their abortion experiences, interviews with 512 providers working in randomly selected hospitals and health centers, and facility assessments of the equipment, drugs, and abortion care guidelines in use at 29 hospitals. Based on this data, the report proposes specific recommendations to decrease the need for second-trimester abortion.