Phenomenology of Induced Abortion in Northern Uganda Among HIV-Positive Women Following an Unintended Pregnancy

Abstract

Background More than half of pregnancies in Uganda are unintended, and nearly a third of these end in abortion. However, little research has focused on women living with HIV’s subjective experiences following induced abortion. We explored how women living with HIV subjectively experience induced abortions in health facilities in Lira District, Uganda. Materials and Methods This was a descriptive-phenomenological study between October and November 2022. The study was conducted among women of reproductive age (15–49 years) who were HIV positive and had undergone induced abortion following an unintended pregnancy. Purposive sampling was used to sample 30 participants who could speak to the research aims and have experience with the phenomenon under scrutiny. The principle of information power was used to estimate the sample size. We conducted face-to-face, in-depth interviews to collect data. Data were presented as direct quotes while providing a contextual understanding of the lived experiences of the study participants. Results The results showed that the major causes of induced abortion were financial constraints, concern for the unborn babies, unplanned pregnancy, and complex relationships. Regarding induced abortion-related experiences, three themes emerged: loss of family support, internalized and perceived stigma, and feelings of guilt and regret. Conclusion This study highlights the lived experiences of women living with HIV following an induced abortion. The study shows that women living with HIV had induced abortions due to numerous reasons, including financial concerns, complicated relationships, and a fear of infecting their unborn babies. However, after induced abortion, the women living with HIV faced several challenges like loss of family support, stigma, and feelings of guilt and regret. Based on HIV-infected women who underwent induced abortion and an unexpected pregnancy, they may need mental health services to reduce the stigma associated with induced abortion.

Scoping review of qualitative studies on family planning in Uganda

“…The perception of abortion care is influenced by the individual’s attitude towards it. Women decide abortion is necessary due to financial constraints, unplanned pregnancy, and complicated social networks [ 98 ]. They may desire to keep their decision to have an abortion private, but that can lead to unsafe abortions and late care-seeking [ 99 ].…”

“…Women often consult many people in their community before deciding on how to access abortion services [ 102 ]. Kabunga et al [ 98 ] found that women who have an abortion experience a loss of family support and internalized perceived stigma.…”

Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study

“…Various factors associated with delayed ANC attendance have been unearthed in low-resource countries. These include unplanned and unconsented pregnancy, increased distance to a health facility, food insecurity, competing demands on family resources, long travel and waiting times, the number of health workers present at the facility and recommendations from village health teams (VHTs) for pregnant mothers to visit health centres to confirm pregnancies 9 10. These factors have been associated with first ANC attendance after 12 weeks of pregnancy among pregnant women 8 11 12.…”