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

Cleeve, Amanda; Faxelid, Elisabeth; Nalwadda, Gorette; Klingberg-Allvin, Marie

doi:10.1080/13691058.2017.1310297

Cited by 42 publications

(69 citation statements)

References 34 publications

(37 reference statements)

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“…Furthermore, as mentioned above, gender-based power relations hindered women from actualising their decisions. Previous studies from Uganda and Ghana have disclosed similar findings where women’s decision-making power regarding abortion was restricted by gender norms and power imbalances [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 63%

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

et al. 2018

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BackgroundUnwanted pregnancies and unsafe abortions are prevalent in regions where women and adolescent girls have unmet contraceptive needs. Globally, about 25 million unsafe abortions take place every year. In countries with restrictive abortion laws, safe abortion care is not always accessible. In Kenya, the high unwanted pregnancy rate resulting in unsafe abortions is a serious public health issue. Gaps exist in knowledge regarding women’s decision-making processes in relation to induced abortions in Kenya. Decision-making is a fundamental factor for consideration when planning and implementing contraceptive services. This study explored decision-making processes preceding induced abortion among women with unwanted pregnancy in Kisumu, Kenya.MethodsIndividual face-to-face in-depth interviews were conducted with nine women aged 19–32 years old. Women who had experienced induced abortion were recruited after receiving post-abortion care at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) or Kisumu East District Hospital (KDH) in Kisumu, Kenya. In total, 15 in-depth interviews using open-ended questions were conducted. All interviews were tape-recorded, transcribed and coded manually using inductive content analysis.ResultsRespondents described their own experiences regarding decision-making preceding induced abortion. This study shows that the main reasons for induced abortion were socio-economic stress and a lack of support from the male partner. In addition, deviance from family expectations and gender-based norms highly influenced the decision to have an abortion among the interviewed women. The principal decision maker was often the male partner who pressed for the termination of the pregnancy indirectly by declining his financial or social responsibilities or directly by demanding termination. In some cases, the male partner controlled decision-making by arranging an unsafe abortion without the woman’s consent. Strategic choices regarding whom to confide in were employed as protection against abortion stigma. This contributed to a culture of silence around abortion and unwanted pregnancy, a factor that made women more vulnerable to complications.ConclusionsThe findings suggest that financial, social and gender-based dependencies influence women’s agency and perceived options in decision-making regarding abortion.

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Section: Discussionmentioning

confidence: 63%

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

et al. 2018

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“…While our framework is grounded in data from post-conflict northern Uganda, it is not unique to this context, but can be applied to research and programmes in other low-income settings. Cleeve et al (2017), for example, describe the pervasive gender inequitable contexts that contribute to unintended pregnancy, including imbalances in economic capital and costs of gender-based violence in a different Ugandan setting. Women in their study embodied the tension between patriarchal and alternative norms, as they reclaimed reproductive agency through family planning.…”

Section: Discussionmentioning

confidence: 99%

Processing gender: lived experiences of reproducing and transforming gender norms over the life course of young people in Northern Uganda

Lundgren

Burgess

Chantelois

et al. 2018

Culture, Health & Sexuality

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The years between 10-19 represent a critical stage of human development during which boys and girls learn and embody socially constructed gender norms, with long-term implications for their sexual and reproductive health. This ethnographic cohort study sought to understand how gendered norms and practices develop during the transition from child to young adult in post-conflict northern Uganda. A total of 60 girls and boys aged 10-19 were selected using purposive sampling for in-depth interviews over a three-year period; 47 individuals completed all four interviews. Drawing on feminist theory and an ecological perspective, findings were used to create a conceptual framework displaying the experiences of young people navigating patriarchal and alternative norms, emphasising their lived processes of performing and negotiating norms within six key domains (work, puberty, family planning, intimate partner relations, child discipline and alcohol). The framework identifies: (1) personal factors (knowledge, agency and aspirations); (2) social factors (socialisation processes, capital, costs and consequences); and (3) structural factors (health/educational systems, religious institutions, government policies) which may encourage young people towards one norm or another as they age. These findings can inform policies and programmes to transform gender norms and promote equitable, healthy relationships.

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“…In this study, we used live births which does not capture all pregnancies-as others end in abortion or stillbirths. Information on induced abortion in Uganda tends to be under reported as it is prohibited other than for prescribed conditions to save the life of a woman [56,57]. Contraceptive use was not examined and yet previous studies indicated that it is a predictor of repeat adolescent birth [41].…”

Section: Limitationsmentioning

confidence: 99%

Time trends in and factors associated with repeat adolescent birth in Uganda: Analysis of six demographic and health surveys

et al. 2020

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BackgroundInformation on repeat adolescent birth remains scarce in sub-Sahara Africa. We investigated the prevalence and time trends in repeat adolescent birth in Uganda, and associated factors. MethodsWe analyzed Uganda Demographic and Health Survey data of women age 20-24 years collected on 6 surveys (1988/89-2016) to estimate repeat adolescent birth (first live birth <18 years of age followed by another live birth(s) <20 years). Further, we estimated the wantedness of the second order birth and the prevalence of short birth intervals birth (<13 months) between the first and second such birth. On the 2016 survey, we examined factors associated with repeat adolescent birth using bivariate and multivariate modified Poisson regression. ResultsAt the 1988/89 survey, 58.9% of women with first birth <18 years reported a repeat adolescent birth. This percentage increased to 66.8% in 2006 (+7.9 percentage points [pp], p = 0.010) and thereafter declined to 55.6% by 2016 (-11.2 pp, p<0.001), nevertheless, no change occurred between 1988/89 and 2016 (-3.3pp, p = 0.251). Among women with repeat adolescent births, the mean number of live births by exact age 20 years (2.2 births) and prevalence of short birth intervals (3.5% in 1988/89, 5.4% in 2016) (+1.9pp, p = 0.245) did not change. Increasingly more women with repeat adolescent births preferred to have had PLOS ONE

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

Cited by 42 publications

References 34 publications

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

Processing gender: lived experiences of reproducing and transforming gender norms over the life course of young people in Northern Uganda

Time trends in and factors associated with repeat adolescent birth in Uganda: Analysis of six demographic and health surveys

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