Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature

Abstract

Adolescent girls comprise a considerable proportion of annual abortion deaths, worldwide, with 15% of all unsafe abortions taking place among girls under 20 years of age. Despite recent global attention to the health and welfare of adolescent girls, little is known about their abortion experience, particularly of those under the age of 15 years. This review examines existing peer-reviewed and grey literature on abortion-related experiences of adolescent girls, paying particular attention to girls ages 10-14. In December 2019, the authors conducted a comprehensive search of five major online resource databases, using a two-part keyword search strategy for articles from 2003 to 2019. Of the original 3,100+ articles, 1,228 were individually screened and 35 retained for inclusion in the analysis. Findings show that while adolescent girls may have knowledge of abortion in general, they lack specific knowledge of sources of care and delay care-seeking due to the fear of stigma, lack of resources and provider bias. Adolescent girls do not experience higher rates of physical complications compared to older cohorts, but they are at risk of psychosocial harm. For girls ages 10-14, abortion experience may be compounded by pregnancy due to sexual abuse or transactional sex, and they face even more barriers to care than older adolescents in terms of provider bias and lack of agency. Adolescents have unique needs and experiences around abortion, which should be accounted for in programming and advocacy. Adolescent girls need information about safe abortion at an early age and a responsive and stigma-free health system.

Reproductive awareness and recognition of unintended pregnancy: young women, key informants and health care providers perspectives in South Africa

“…Although women’s reactions to an unplanned pregnancy have been described as individual and not predictable [ 21 ], internal assets such as knowledge around accurate timing for pregnancy testing or supportive social networks can be expected to assist with timely care-seeking, or avoidance of delay. For women preferring to see a health care provider to confirm their pregnancy status, the onerous process at the clinic as well as negative healthcare provider attitudes are barriers in this setting and have also been reported elsewhere [ 22 ].…”

Perspectives on Awareness of Unintended Pregnancy Among Young South African Women, Healthcare Providers and Policy Makers

“…Although women's reactions to an unplanned pregnancy have been described as individual and not predictable (12), internal assets such as knowledge of pregnancy testing or supportive social networks can be expected to assist with timely care-seeking, or avoidance of delay. For women preferring to see a health care provider to con rm their pregnancy status, the onerous process at the clinic as well as negative healthcare provider attitudes are barriers in this setting and have also been reported elsewhere (13).…”

Economic and social dimensions influencing safety of induced abortions amongst young women who sell sex in Zimbabwe

“…25 Compared to older women, adolescents generally have less knowledge of health services and this will negatively influence their healthcare-seeking behaviour. 2 Greater effort should be made in creating awareness around the availability of PAC services and ensuring that facilities do not charge for what, according to Zimbabwean national policy, should be freely provided. 10 Limitations There were several limitations to the study.…”

“…1 Young age is another important determinant of vulnerability to unsafe abortions and concomitant access to care. 2 Young women and adolescents bear a considerable burden of least safe abortions in developing regions, with 41% of "least safe" (the term is discussed below) abortions occurring amongst young women aged 15-24 years. 3 Half of least safe abortions in Africa, a region widely characterised by restrictive abortion laws, occur amongst young women aged 15-24 years.…”