Abstract
BackgroundWomen use various terms when discussing the management of their fertility and menstrual irregularities and may interpret the experience of ending a possible pregnancy in nuanced ways, especially when their pregnancy status is ambiguous. Our study aims to understand the terminology used to refer to abortion-like experiences (specifically menstrual regulation and pregnancy removal), and the specific scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d’Ivoire.MethodsOur analysis draws upon surveys with women in Nigeria (n = 1114) and Cote d’Ivoire (n = 352). We also draw upon qualitative in-depth interviews with a subset of survey respondents in Anambra and Kaduna States in Nigeria, and Abidjan, Cote d’Ivoire (n = 30 in both countries). We examine survey and interview questions that explored women’s knowledge of terminology pertaining to ending a pregnancy or bringing back a late period. Survey data were analyzed descriptively and weighted, and interview data were analyzed using inductive thematic analysis.ResultsWe find that the majority (71% in Nigeria and 70% in Côte d’Ivoire) of women perceive menstrual regulation to be a distinct concept from pregnancy removal, yet there is considerable variability in whether specific scenarios are interpreted as referring to menstrual regulation or pregnancy removal. Menstrual regulation is generally considered to be more ambiguous and not dependent on pregnancy confirmation in comparison to pregnancy removal, which is consistently interpreted as voluntary termination of pregnancy.ConclusionsOverall, menstrual regulation and pregnancy removal are seen as distinct experiences in both settings. These findings have relevance for researchers aiming to document abortion incidence and experiences, and practitioners seeking to address women’s reproductive health needs.
Highlights
Achieving the Sustainable Development Goals (SDGs) requires addressing long neglected sexual and reproductive health issues, such as access to safe abortion [1]
Our study aims to understand the terminology women use to refer to abortionlike experiences, and the specific scenarios that these practices encompass among women who reported having had an abortion in Côte d’Ivoire and Nigeria
We find that the majority (71% in Nigeria and 70% in Côte d’Ivoire) of women perceive menstrual regulation to be a distinct concept from pregnancy removal, yet there is considerable variability in whether specific scenarios are interpreted as referring to menstrual regulation or pregnancy removal
Summary
Achieving the Sustainable Development Goals (SDGs) requires addressing long neglected sexual and reproductive health issues, such as access to safe abortion [1]. For some women, deciding not to confirm a pregnancy can be advantageous to their sense of self and their social reputation—Bell and Fissell describe this state of uncertainty surrounding pregnancy identification as “productive ambiguity” [5]. This ambiguity can allow women to seek treatment without identifying the treatment as an abortion due to the absence of pregnancy confirmation. Our study aims to understand the terminology used to refer to abortion-like experiences ( menstrual regulation and pregnancy removal), and the specific scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d’Ivoire
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