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.
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DOI：
10.1186/s12978-018-0612-6
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发表时间：
2018-10-03
影响因子：
3.4
通讯作者：
Klingberg-Allvin M
中科院分区：
文献类型：
--
作者：
Rehnström Loi U;Lindgren M;Faxelid E;Oguttu M;Klingberg-Allvin M
在妇女和少女避孕需求得不到满足的地区，意外怀孕和不安全堕胎十分普遍。全球每年约有2 500万例不安全堕胎。在实行限制性堕胎法的国家，安全堕胎护理并不总是可以获得的。在肯尼亚，意外怀孕率很高，导致不安全堕胎，这是一个严重的公共卫生问题。在肯尼亚，对妇女在人工流产方面的决策过程的了解存在差距。在规划和实施避孕服务时，决策是一个基本考虑因素。本研究探讨了肯尼亚基苏穆非意愿妊娠妇女人工流产前的决策过程。对9名年龄在19-32岁之间的妇女进行了个人面对面的深入访谈。在肯尼亚基苏穆的Jaramogi Oginga Odinga教学和转诊医院（JOOTRH）或基苏穆东区医院（KDH）接受流产后护理的妇女被招募。总共进行了15次使用开放式问题的深入访谈。所有访谈都进行了录音、转录和使用归纳内容分析进行人工编码。受访者描述了他们自己在人工流产前决策的经历。这项研究表明，人工流产的主要原因是社会经济压力和缺乏男性伴侣的支持。此外，对家庭期望和基于性别的规范的偏离在很大程度上影响了受访妇女堕胎的决定。主要的决策者往往是男性伴侣，他们通过拒绝承担经济或社会责任或直接要求终止妊娠来间接地要求终止妊娠。在某些情况下，男性伴侣通过安排未经妇女同意的不安全堕胎来控制决策。关于向谁倾诉的战略选择被用来保护人们免受堕胎的耻辱。这促成了对堕胎和意外怀孕保持沉默的文化，这一因素使妇女更容易出现并发症。调查结果表明，财政、社会和基于性别的依赖性影响妇女在堕胎决策中的代理权和感知选择。
Unwanted 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. Individual 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. Respondents 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. The 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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影响因子：
4.5
作者：
Rehnström Loi U;Gemzell-Danielsson K;Faxelid E;Klingberg-Allvin M
通讯作者：
Klingberg-Allvin M
影响因子：
2.2
作者：
Kebede, Meselu Taye;Hilden, Per Kristian;Middelthon, Anne-Lise
通讯作者：
Middelthon, Anne-Lise
影响因子：
4.5
作者：
Maina BW;Mutua MM;Sidze EM
通讯作者：
Sidze EM
影响因子：
3.8
作者：
Elo, Satu;Kyngaes, Helvi
通讯作者：
Kyngaes, Helvi
影响因子：
1.6
作者：
Hessini, Leila
通讯作者：
Hessini, Leila