TY - JOUR
T1 - Managing unplanned pregnancies in five countries
T2 - Perspectives on contraception and abortion decisions
AU - Tsui, Amy O.
AU - Casterline, John
AU - Singh, Susheela
AU - Bankole, Akinrinola
AU - Moore, Ann M.
AU - Omideyi, Adekunbi Kehinde
AU - Palomino, Nancy
AU - Sathar, Zeba
AU - Juarez, Fatima
AU - Shellenberg, Kristen M.
N1 - Funding Information:
This is a revision of a paper presented at the seminar on ‘Interrelationships between contraception, unintended pregnancy and induced abortion’, Addis Ababa, Ethiopia, 1·3 December 2008. The seminar was organised by the IUSSP Scientific Panel on Abortion and Ipas-Ethiopia. Research assistance from Davida Becker, YeMon Myint, and Marissa Pine Yeakey is gratefully acknowledged. The comments of two reviewers are also much appreciated. The multi-country collaborative study was supported in part by the Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health.
PY - 2011/9
Y1 - 2011/9
N2 - Why is induced abortion common in environments in which modern contraception is readily available? This study analyses qualitative data collected from focus group discussions and in-depth interviews with women and men from lowincome areas in five countries - the United States, Nigeria, Pakistan, Peru and Mexico - to better understand how couples manage their pregnancy risk. Across all settings, women and men rarely weigh the advantages and disadvantages of contraception and abortion before beginning a sexual relationship or engaging in sexual intercourse. Contraception is viewed independently of abortion, and the two are linked only when the former is invoked as a preferred means to avoiding repeat abortion. For women, contraceptive methods are viewed as suspect because of perceived side effects, while abortion experience, often at significant personal risk to them, raises the spectre of social stigma and motivates better practice of contraception. In all settings, male partners figure importantly in pregnancy decisions and management. Although there are inherent study limitations of small sample sizes, the narratives reveal psychosocial barriers to effective contraceptive use and identify nodal points in pregnancy decisionmaking that can structure future investigations.
AB - Why is induced abortion common in environments in which modern contraception is readily available? This study analyses qualitative data collected from focus group discussions and in-depth interviews with women and men from lowincome areas in five countries - the United States, Nigeria, Pakistan, Peru and Mexico - to better understand how couples manage their pregnancy risk. Across all settings, women and men rarely weigh the advantages and disadvantages of contraception and abortion before beginning a sexual relationship or engaging in sexual intercourse. Contraception is viewed independently of abortion, and the two are linked only when the former is invoked as a preferred means to avoiding repeat abortion. For women, contraceptive methods are viewed as suspect because of perceived side effects, while abortion experience, often at significant personal risk to them, raises the spectre of social stigma and motivates better practice of contraception. In all settings, male partners figure importantly in pregnancy decisions and management. Although there are inherent study limitations of small sample sizes, the narratives reveal psychosocial barriers to effective contraceptive use and identify nodal points in pregnancy decisionmaking that can structure future investigations.
KW - Contraception
KW - Contraceptive behaviour
KW - Couples
KW - Induced abortion
KW - Pregnancy
KW - Unplanned
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U2 - 10.1080/17441692.2011.597413
DO - 10.1080/17441692.2011.597413
M3 - Article
C2 - 21756080
AN - SCOPUS:79961082917
SN - 1744-1692
VL - 6
SP - S1-S24
JO - Global public health
JF - Global public health
IS - SUPPL.1
ER -