Family planning practices of women working in the Cambodian garment industry: a qualitative study

Abstract

Background: Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care. Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 min and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol. Results: We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women's attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children.

Abortion decision-making process trajectories and determinants in low- and middle-income countries: A mixed-methods systematic review and meta-analysis

“… 8 , 12 , 26 , 30 , 31 , 32 , 33 , 35 , 37 , 39 , 40 , 41 , 42 The woman may then disclose or conceal the pregnancy or her initial decision to her close networks including partner, parents, siblings, teachers and other close friends depending upon the level of trust, perceived reaction to the woman's decision and expected support. 8 , 12 , 31 , 33 , 35 , 36 , 38 , 39 , 43 , 44 , 45 , 48 …”

“…The final abortion decision may be made solely or primarily by the woman herself, jointly with her partner or others, or by others without or with minimal involvement of the woman. 7 , 8 , 10 , 12 , 26 , 27 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 44 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 74 However, even cases in which the majority of the decisions are made by woman, male partners and/or parents still influenced her decision. 7 , 35 , 39 , 44 , 74 Thus, decisions made by woman may either be passive in which the woman simply agrees to the decision imposed onto her by others 8 , 30 , 32 , 35 , 37 , 38 , 39 , 44 , 48 ,…”

A study of knowledge, awareness, and acceptance of contraception among reproductive age women at tertiary care hospital, Ahmedabad

“…10 A qualitative study conducted in Phnom Penh city, Cambodia, confirmed that if one reduces fertility, there will be fewer children and it would be easier to earn a living. 11 Another positive attitude was seen in subjects who mentioned that they would like to use contraception after delivery. This would motivate women to practice family planning using contraceptive methods.…”

Development of an intervention to support reproductive health of garment factory workers in Cambodia: a qualitative study

“…Findings from these interviews are reported elsewhere. 12 During the course of the project, we organised several meetings to share and discuss behaviours observed in research that could feasibly be targeted and potential interventions resulting from the needs assessment activities, and then design, produce and refine a pilot intervention. In order to address limitations in the provision of accessible contraceptive information and information materials for factory workers in general and specifically at the time of seeking medical abortion, we decided to make three 'edutainment' videos about family planning and one instructional video about how to take medical abortion correctly.…”

“…15 The videos were designed to target barriers to contraception use that were identified in the needs assessment, ethnographic and interviews studies. 12 The videos were released through MSIC's communication channels and their impact was evaluated by an independent digital media company (Havas Champagne media). 16 Patient and public involvement Neither patients nor the public were involved in the development of the research question, study design or outcome measures.…”