Lived experiences and drivers of induced abortion among women in central Uganda.

Although unsafe abortions are preventable, they are one of the leading causes of maternal mortality and morbidity. Despite the serious potential health consequences, there is limited published information about drivers and challenges of obtaining abortions in restrictive settings such as Uganda. Thi...

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Main Authors: Simon Peter Sebina Kibira, Melissa Stillman, Fredrick E Makumbi, Margaret Giorgio, Sarah Nabukeera, Grace Kigozi Nalwoga, Elizabeth A Sully
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002236&type=printable
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author Simon Peter Sebina Kibira
Melissa Stillman
Fredrick E Makumbi
Margaret Giorgio
Sarah Nabukeera
Grace Kigozi Nalwoga
Elizabeth A Sully
author_facet Simon Peter Sebina Kibira
Melissa Stillman
Fredrick E Makumbi
Margaret Giorgio
Sarah Nabukeera
Grace Kigozi Nalwoga
Elizabeth A Sully
author_sort Simon Peter Sebina Kibira
collection DOAJ
description Although unsafe abortions are preventable, they are one of the leading causes of maternal mortality and morbidity. Despite the serious potential health consequences, there is limited published information about drivers and challenges of obtaining abortions in restrictive settings such as Uganda. This limits efforts to improve programing for preventing unsafe abortion and providing comprehensive post abortion care. This study sought to understand the drivers and explain the lived abortion experiences among women from central Uganda, in an effort to promote greater access to safe reproductive healthcare services, and reduce unsafe abortions. This qualitative study included 40 purposely selected women who self-reported an abortion, living in Kampala and greater Rakai district, Uganda. They were part of a larger survey using respondent driven sampling, where seed participants were recruited from selected facilities offering post-abortion care, or through social referrals. Data were collected from May to September 2021 through in-depth interviews. Audio data were transcribed, managed using Atlas.ti 9, and analyzed thematically. The findings show that the underlying drivers stemmed from partners who were unsupportive, denied responsibility, or had raped/defiled women. Career and education decisions, stigma and fear to disappoint family also contributed. Women had feelings of confusion, neglect, betrayal, or shame after conception. Abortion and post-abortion experiences were mixed with physical and emotional pain including stigma, even when the conditions for safe abortion in the guidelines were satisfied. Although most women sought care from health facilities judged to provide safe and quality care, there was barely any counselling in these venues. Confidantes and health providers informed the choice of abortion methods, although the cost ultimately mattered most. The mental health of women whose partners are unsupportive or who conceive unintendedly need consideration. Abortion provided psychological relief from more complicated consequences of having an unplanned birth for women.
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spelling doaj.art-6f68c4df7dd742578cb2dbd9d4f4e3222023-12-26T05:55:40ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-01312e000223610.1371/journal.pgph.0002236Lived experiences and drivers of induced abortion among women in central Uganda.Simon Peter Sebina KibiraMelissa StillmanFredrick E MakumbiMargaret GiorgioSarah NabukeeraGrace Kigozi NalwogaElizabeth A SullyAlthough unsafe abortions are preventable, they are one of the leading causes of maternal mortality and morbidity. Despite the serious potential health consequences, there is limited published information about drivers and challenges of obtaining abortions in restrictive settings such as Uganda. This limits efforts to improve programing for preventing unsafe abortion and providing comprehensive post abortion care. This study sought to understand the drivers and explain the lived abortion experiences among women from central Uganda, in an effort to promote greater access to safe reproductive healthcare services, and reduce unsafe abortions. This qualitative study included 40 purposely selected women who self-reported an abortion, living in Kampala and greater Rakai district, Uganda. They were part of a larger survey using respondent driven sampling, where seed participants were recruited from selected facilities offering post-abortion care, or through social referrals. Data were collected from May to September 2021 through in-depth interviews. Audio data were transcribed, managed using Atlas.ti 9, and analyzed thematically. The findings show that the underlying drivers stemmed from partners who were unsupportive, denied responsibility, or had raped/defiled women. Career and education decisions, stigma and fear to disappoint family also contributed. Women had feelings of confusion, neglect, betrayal, or shame after conception. Abortion and post-abortion experiences were mixed with physical and emotional pain including stigma, even when the conditions for safe abortion in the guidelines were satisfied. Although most women sought care from health facilities judged to provide safe and quality care, there was barely any counselling in these venues. Confidantes and health providers informed the choice of abortion methods, although the cost ultimately mattered most. The mental health of women whose partners are unsupportive or who conceive unintendedly need consideration. Abortion provided psychological relief from more complicated consequences of having an unplanned birth for women.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002236&type=printable
spellingShingle Simon Peter Sebina Kibira
Melissa Stillman
Fredrick E Makumbi
Margaret Giorgio
Sarah Nabukeera
Grace Kigozi Nalwoga
Elizabeth A Sully
Lived experiences and drivers of induced abortion among women in central Uganda.
PLOS Global Public Health
title Lived experiences and drivers of induced abortion among women in central Uganda.
title_full Lived experiences and drivers of induced abortion among women in central Uganda.
title_fullStr Lived experiences and drivers of induced abortion among women in central Uganda.
title_full_unstemmed Lived experiences and drivers of induced abortion among women in central Uganda.
title_short Lived experiences and drivers of induced abortion among women in central Uganda.
title_sort lived experiences and drivers of induced abortion among women in central uganda
url https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002236&type=printable
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