Abstract to complications. Conclusions: The findings suggest that

Abstract

Background:

Unintended pregnancy and
unsafe abortion are prevalent in regions where women and adolescent girls have
unmet need for contraceptives. Globally, about 25 million unsafe abortions take place every year. In countries
where restrictive abortion laws are common, safe abortion care is not always
accessible to women in need. In Kenya, the high rate of unintended pregnancy
resulting in unsafe abortions is a serious public health issue. Gaps exist in
knowledge regarding women’s decision-making process in relation to induced
abortion in Kenya. This is a fundamental factor to be considered when planning
and implementing contraceptive services. This study explored women´s experience
of decision-making preceding induced abortion when confronted with an
unintended pregnancy in Kisumu, Kenya.

Methods: 

Individual, face-to-face in-depth interviews
were conducted with nine women 19-32 years old. Women who experienced induced
abortion were recruited after receiving post-abortion care at the Jaramogi
Oginga Odinga Teaching and Referral Hospital (JOOTRH) and Kisumu East District
Hospital (KDH) in Kisumu, Kenya. In total, 15 in-depth interviews using
open-ended questions and a non-judgmental approach were conducted. All
interviews were tape-recorded, transcribed and coded manually into categories
using inductive content analysis.

Results: 

Respondents described their own experiences
regarding decision-making preceding induced abortion. This study shows that the
main reasons for induced abortion were socio-economic distress and lack
of support by the male partner. In addition, deviance from family- and gender-based norms highly influenced abortion
decision-making among the interviewed women. The principal decision maker was
the male partner who pressed the woman to terminate the pregnancy indirectly
through rejection of financial or social responsibilities or directly by
commanding her to terminate the pregnancy. In some cases, the male partner
mastered her decision to continue the pregnancy by arranging an unsafe abortion
without her consent. Strategic choices regarding whom to confide in were
employed as a protection against abortion stigma. This contributed to a culture
of silence around abortion and unwanted pregnancy, a
fact that made women more vulnerable to complications.

Conclusions: 

The findings suggest that financial, social and gender-based
dependencies influence women’s agency and perceived options in abortion
decision-making.

Keywords:
abortion, decision-making, qualitative methodology, in-depth interviews, Kenya

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