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

Abstract

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.

“I wasn’t ready”: abortion decision-making pathways in Ouagadougou, Burkina Faso

“…Combining women's and men's views, this study shows the important role of both the woman and her partner, as well as the family and friends, in the abortion decisionmaking process, as described in other studies (Kumi-Kyereme et al 2014;Ekstrand et al 2009). In Burkina Faso where the woman is not granted abortion decision-making rights by the government, intimate partners can be deeply involved in the abortion decision making, using a range of methods from arguing to emotional blackmail to overt force.…”

“…Women's reasons include a desire to postpone/space childbearing, concerns that they are too young to become parents, are carrying a stigmatized pregnancy (premarital or adulterous relationship' pregnancy, for example) and financial constraints, among many others. The bulk of the existing literature on decision making focuses on the driving factors (fertility intentions, norms, resources, law) as well as the decision outcomes (Coast et al 2018;Orner et al 2010;Orner et al 2011;Frederico et al 2018;Kumi-Kyereme et al 2014;Whittaker 2002). The dynamic of the decision-making process itself-structures, sequences, time frame-has been overlooked, especially in restrictive contexts.…”

“…The evidence on abortion decision making comes mostly from settings with less restrictive abortion policy environments and provides insights into the process (starting from the reactions, impact factors and tools for process), as well as the actors involved and power relationship, and how the dynamic within the process can lead to delays in seeking abortion (Harries et al 2007;Ekstrand et al 2009;Friedlander et al 1984;Donati et al 2002;Holmberg and Wahlberg 2000). In restrictive settings where legislation does not confer any decision-making authority to women (it is granted instead, in limited legal circumstances to doctors and judges), some studies have documented the key role of the partners and family members in the decision-making process (Kumi-Kyereme et al 2014). However, they do not inform on how these actors as well as the legislation shape the process, especially the time frame, and the patterns of negotiation.…”

Pregnancy options counselling in Ghana: A case study of women with unintended pregnancies in Kumasi metropolis, Ghana

“…Education has been found to play a vital role in abortion decision-making [8][21]. In this current study, it was noted that increasing education level beyond the basic education confers statistically significant effect on being exposed to counselling.…”

“My friend who bought it for me, she has had an abortion before.” The influence of Ghanaian women’s social networks in determining the pathway to induced abortion

“…Prosecution of women, or their providers, due to inducing an abortion is rare,14 but women are afraid of this potentiality. As one woman said, “If they had seen me, then I would have been arrested but now that no one has seen me, I think I am safe”.…”