Pathways to unsafe abortion in Ghana: the role of male partners, women and health care providers

Schwandt, Hilary; Creanga, Andreea A.; Adanu, Richard; Danso, Kwabena A.; Agbenyega, Tsiri; Hindin, Michelle J.

doi:10.1016/j.contraception.2013.03.010

Cited by 59 publications

(85 citation statements)

References 21 publications

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“…In our study, the social world in which agency was negotiated and enacted was fraught with power imbalances and contradicting norms and expectations; thus, our respondents may be viewed as 'having little' agency. Nevertheless, through their actions our respondents influenced their sexual and reproductive health and regained some control over their lives, and thereby they are also part of changing history and the world they engage with (Ortner 2006 Earlier studies from settings in Africa (Rossier 2007;Schwandt et al 2013) have revealed how prospects of economic support and a socially accepted pregnancy may determine the abortion decision; this was also seen in our study. Our findings illustrate the contradictory pressures that gender norms impose on women and the power embedded in and inflicted by stigma.…”

Section: Discussionsupporting

confidence: 67%

“…Similarly to preceding studies (Schwandt et al 2013;Shellenberg et al 2011) secrecy was an important tactic that enabled agentive action while avoiding stigma and appearing to adhere to established social norms. However, our study revealed the health implications of maintaining secrecy as a lack of resources, coupled with the need to avoid exposure, resulted in delayed care-seeking.…”

Section: Discussionmentioning

confidence: 99%

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Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda

Cleeve

Faxelid

Nalwadda

et al. 2017

Culture, Health & Sexuality

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Unsafe abortion in Africa continues to be a major contributor to the global maternal mortality which affects young women in particular. In Uganda, where abortion is legally restricted and stigmatised, unsafe abortion is a major public health issue. We explored reproductive agency in relation to unsafe abortion among young women seeking post-abortion care. Through in-depth interviews we found that reproductive agency was constrained by gender norms and power imbalances and strongly influenced by stigma. Lack of resources and the need for secrecy resulted in harmful abortion practices and delayed care-seeking. Women did not claim ownership of the abortion decision, but the underlying meaning in the narratives positioned abortion as an agentive action aiming to regain control over one′s body and future. Women′s experiences shaped contraceptive intentions and discourse, creating a window of opportunity that was often missed. This study provides unique insight into how young women negotiate and enact reproductive agency in Uganda. Health systems need to strengthen their efforts to meet young women's sexual and reproductive health needs and protect their rights. Enabling young women's agency through access to safe abortion and contraception is paramount.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda

Cleeve

Faxelid

Nalwadda

et al. 2017

Culture, Health & Sexuality

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show abstract

“…In Africa and Latin America, approximately 30 unsafe abortions occurred per 1000 women aged 15–44 years, although the range of estimates for Africa is wide [2]. In Ghana, induced abortion is reported to be the second highest cause of maternal mortality, regardless of the fact that it is generally legal [3]. …”

Section: Introductionmentioning

confidence: 99%

“…As a way of dealing with the nuances that surround abortion, some women tend to solicit the approval/consent of other people to help make the decision and to have the decision validated and implemented [7]. In other instances, women may be compelled through “orders” to abort, or by circumstances such as the father denying responsibility for the pregnancy [3]. …”

Section: Introductionmentioning

confidence: 99%

Role-players in abortion decision-making in the Accra Metropolis, Ghana

2014

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BackgroundMaking the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana.MethodsA retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data.ResultsThe findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and “Others” (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations.ConclusionA number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision.

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“…This study will also examine whether the survey mode effect differs by gender. Research has shown gender differences on attitudes toward abortion (Finlay, 1981;Lohan, Cruise, O'Halloran, Alderdice, & Hyde, 2011;Schwandt et al, 2013). Women hold more liberal attitudes and a higher approval of women's autonomy in abortion decisions than men (Patel & Johns, 2009).…”

Section: Introductionmentioning

confidence: 99%

Data Collection Mode Effect on Abortion Questions: A Comparison of Face-To-Face and Web Surveys

Liu¹

2018

Gend Womens Stud

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Pathways to unsafe abortion in Ghana: the role of male partners, women and health care providers

Cited by 59 publications

References 21 publications

Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda

Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda

Role-players in abortion decision-making in the Accra Metropolis, Ghana

Data Collection Mode Effect on Abortion Questions: A Comparison of Face-To-Face and Web Surveys

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