'The lesser evil'-Abortion and reproductive stigma among Ethiopian university students.

Unintended pregnancy: Consequences and solutions for a worldwide problem

BackgroundInduced abortion is one of the greatest human rights dilemmas of our time. Yet, abortion is a very common experience in every culture and society. According to the World Health Organization, Ethiopia had the fifth largest number of maternal deaths in 2005 and unsafe abortion was estimated to account for 32% of all maternal deaths in Ethiopia. Youth are disproportionately affected by the consequences of unsafe abortion. The objective of this study was, therefore, to determine the magnitude and identify factors associated with abortion among female Wolaita Sodo University students.MethodsA descriptive, cross-sectional study was conducted in Wolaita Sodo University between May and June 2011. Data were collected from 493 randomly selected female students using structured and pre-tested questionnaires.ResultsThe rate of abortion among students was found to be 65 per 1000 women, making it three fold the national rate of abortion for Ethiopia (23/1000 women aged 15–44). Virtually all of the abortions (96.9%) were induced and only half (16) were reported to be safe. Students with history of alcohol use, who are first-year and those enrolled in faculties with no post-Grade 10 Natural Science background had higher risk of abortion than their counterparts. About 23.7% reported sexual experience. Less than half of the respondents (44%) ever heard of emergency contraception and only 35.9% of those who are sexually experienced ever used condom.ConclusionsHigh rate of abortion was detected among female Wolaita Sodo University students and half of the abortions took place/initiated under unsafe circumstances. Knowledge of students on legal and safe abortion services was found to be considerably poor. It is imperative that improved sexual health education, with focus on safe and legal abortion services is rendered and wider availability of Youth Friendly family planning services are realized in Universities and other places where young men and women congregate.

Globally as well as in the developing world unintended pregnancies are among the major social and health problems. In Ethiopia, 54% of pregnancies to girls under age 15 are unwanted. In some countries where accesses to safe and legal abortion services are restricted, unsafe abortion is the cause for more than 30% of maternal deaths. The aim of this study was to assess factors associated with unwanted pregnancy among female students of Madawalabu University from 01- 21, March 2014. A cross sectional study was conducted among 814 female students of Madawalabu university drawn randomly from 6 selected schools in 01- 21, March 2014. Self administered questionnaire, adapted from previous relevant studies was used to assess Factors associated with unwanted pregnancy among female students of Madawalabu University. Data was entered, cleaned and then analyzed using Bivariate and multivariate logistic regression models. A total of 814 female students responded to the questionnaire adequately making the response rate of 96%. The mean age of study participants was 20.74 years with standard deviation of 1.47. The overall prevalence of unwanted pregnancy among those who ever had sexual intercourse was 8.1% and among all study participants it was 32.4%. Ever hearing about family planning, consistent use of family planning in the last twelve months, and drinking alcohol in the last one week were among significantly associated with unwanted pregnancy Thus, Madawalabu University HIV/AIDS prevention and control office and other stakeholders are recommended to promote extensively family planning utilization to avoid unwanted pregnancies.

Rape is a frightening crime for women because the impact of rape is not only felt when the crime is committed, but also affects the future. One of them is an unwanted pregnancy. For rape victims, the choice of continuing an unwanted pregnancy or having an abortion is an equally difficult choice. Basically, abortion is clearly a prohibited act, both legally, morally, ethically, decently, and religiously. Although prohibited, abortion cases in Indonesia actually show an increase every year. In response to the problem of abortion for victims of rape, the government has given birth to Law Number 36 of 2009 concerning Health. However, since the legal umbrella was born, it has been minimal and in fact there have been almost no rape victims who have used this safe abortion practice as a way to abort their unwanted abortion. This happens because of problems in the field of practice, it is not as easy as the description of the theory set forth in the legislation. While almost every day rape victims continue to fall in all parts of Indonesia. To answer this problem, the author conducts research using normative juridical methods. Thus it is expected to be able to find problems or problems in the implementation of abortion for victims of rape based on Law Number 36 of 2009 concerning Health. The research shows that there are three problems in Law Number 36 Year 2009 regarding Health which makes it difficult for rape victims to obtain safe and legal abortion services. These problems include the maximum obstetrical age of 40 days for abortion for rape victims to be considered too short, the Ministry of Health has never prepared training requirements for medical personnel and counseling training for abortion for rape victims, then health services that meet the conditions set by the Minister is still very limited and cannot be easily accessed in any part of Indonesia. Therefore, the problematic implementation of legal and safe abortion for rape victims found in the Health Act must be immediately corrected, so that rape victims do not return to become victims due to the implementation of unsafe illegal abortion practices.

As part of a Population Council program of research on unwanted pregnancy and induced abortion in Rajasthan, the Council and Ibtada conducted a qualitative exploration of attitudes and behaviors regarding unwanted pregnancy and induced abortion in Alwar district. The study was intended to lay the groundwork for two quantitative studies on abortion undertaken subsequently in six districts of Rajasthan. The qualitative exploration shows that women, particularly those who are poor, turn to largely untrained community-level providers for abortion services. Additionally, women use home remedies in an often unsuccessful attempt to terminate unwanted pregnancies. Women with greater financial means obtain surgical services from a private gynecologist. The remaining women are left with little choice but to avail of services from informal providers that they often recognize to be unsafe and/or to carry unwanted pregnancies to term. This report encourages innovative means to improve access to legal, safe, and effective abortion services at lower levels of the public health system, and suggests that the feasibility of training certain informal providers to offer safe abortion services, particularly at early gestations, should be explored at the policy, program, and research levels.

BackgroundDespite Nepal’s progressive legal framework permitting abortion, young women continue to face barriers in accessing safe abortion services (SAS), leading to preventable maternal mortality and morbidity. This study aimed to identify the key obstacles to SAS access among young women in the Makwanpur district of Nepal.MethodsA convergent mixed-methods study was conducted in 2018. The quantitative component involved a cross-sectional survey of 447 female students aged 18–34, using a structured questionnaire to assess knowledge, stigma (via the Stigmatizing Attitudes, Beliefs, and Actions Scale - SABAS), and access to SAS. Multivariable logistic regression identified factors associated with low access. The qualitative component included six in-depth interviews with post-abortive women (PAWs), four with abortion service providers (ASPs), and three focus group discussions (FGDs) with 26 young community women. Data were analyzed thematically and integrated to provide a comprehensive understanding.ResultsQuantitatively, only 54.14% of respondents had high access to SAS. Key factors associated with low access included high abortion stigma (AOR: 2.97, 95% CI: 1.06–8.35), no internet use (AOR: 1.99, 95% CI: 1.02–3.86), and no contact with Female Community Health Volunteers (FCHVs) (AOR: 2.20, 95% CI: 1.21–4.31). While 70.69% knew abortion was legal, knowledge of specific legal conditions and free services was limited (47%). Qualitatively, seven key barriers emerged: [1] critical knowledge gaps about legality and service availability; [2] financial constraints, particularly for transportation; [3] pervasive abortion stigma and discrimination, especially against unmarried women; [4] geographical inaccessibility in rural areas; [5] marital status discrimination; [6] concerns about service quality and confidentiality; and [7] a lack of trained providers and resources, particularly for manual vacuum aspiration (MVA).ConclusionA complex interplay of informational, social, financial, and structural barriers impedes young women’s access to safe abortion in Nepal. Interventions must be multi-faceted, including targeted awareness campaigns (leveraging media and FCHVs), stigma reduction programs, expansion of services in rural areas, and strengthening of healthcare provider training and resources to ensure equitable access to safe abortion for all young women.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-25494-y.

BackgroundFactors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where...

Although safe abortion is a human right, some research indicates that abortion can be considered a life event that could trigger an adverse psychological reaction, including mental ill health, particularly in vulnerable women. Unplanned pregnancies and abortions affect women's mental and physical health while increasing psychological risk; hence, measures are needed to improve the quality of life (QoL) of women post termination of pregnancy (ToP). The purpose of this study was to explore the psychological effects of abortion on women provided with this service in Rwanda, and factors surrounding QoL after service provision. An interpretive description design was used. Focus group discussions were used to hear the voices of 30 women and girls who had sought ToP services. The six steps of interpretive description together with framework analysis guided the analysis. From responses provided by the participants with experience of ToP services five themes and six sub-themes were generated, (1) Ambivalence with mixed feelings and uncertainty, anger, wonder, and frustration; (2) Insecurity and abortion stigma, with judgement and inadequacy; (3) Personalized care with respectful care and dignity and self-reliance; (4) Lack of connection with relationships, coping, and a sense of belonging; (5) Wellness and preferences for care with hope and positive physical health. The lack of psychological support post ToP negatively affects QoL and indicates an opportunity to include a psychological support package in the ToP service provision, which is the predictor of positive mental health to improve QoL in Rwanda.

Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them. Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. Women's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences.

BackgroundEthiopia has one of the highest maternal mortality ratios in the world (420 per 100,000 live births in 2013), and unsafe abortion continues to be one of the major causes. To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia.MethodsThis paper draws on results from nationally representative health facility studies conducted in Ethiopia in 2008 and 2014. The data come from three sources at two points in time: 1) interviews with 335 health providers in 2008 and 822 health care providers in 2014, 2) review of facility logbooks, and 3) prospective data on 3092 women in 2008 and 5604 women in 2014 seeking treatment for abortion complications or induced abortion over a one month period. The Safe Abortion Care Model was used as a framework of analysis.ResultsThere has been a rapid expansion of health facilities eligible to provide legal abortion services in Ethiopia since 2008. Between 2008 and 2014, the number of facilities reporting basic and comprehensive signal functions for abortion care increased. In 2014, access to basic abortion care services exceeded the recommended level of available facilities providing the service, increasing from 25 to 117%, with more than half of regions meeting the recommended level. Comprehensive abortion services increased from 20% of the recommended level in 2008 to 38% in 2014. Smaller regions and city administrations achieved or exceeded the recommended level of comprehensive service facilities, yet larger regions fall short. Between 2008 and 2014, the use of appropriate technology for conducting first and second trimester abortion and the provision of post abortion family planning has increased at the same time that abortion-related obstetric complications have decreased.ConclusionTen years after the change in abortion law, service availability and quality has increased, but access to lifesaving comprehensive care still falls short of recommended levels.

The general objective of this research is to assess the effects of Face book on the making and unmaking of University students socio-political activities. To achieve the objective, both primary and secondary sources of data were collected and interpreted using mixed research approach. As far as primary sources of data were concerned, first hand information collected from 500 University students via questionnaires, interviews and focus group discussions. Furthermore, the primary data were substantiated by secondary sources. Using the data the researchers reached upon the following conclusions; the general assessment of facebook usage among Ethiopian public University students is in perspectives. The effects of facebook usage on Ethiopian university students’ academic performances, is in perspective. Majority of the university students explain the positive contribution of facebook on students’ academic performance while some others tudents are explain as facebook usage affects their academic performances negatively. In similar manner, facebook usage has both positive and negative effects on University students’ social interactions. Facebook helps students to deliver message accurately at all time, contact with relatives and friends at distance with less cost and easily while it deteriorated social gathering and discussion, and promote individualism. However, in relation to facebook usage and political activism, the finding shows that majority of Ethiopian University students are passive in overtly participating in online political activism. Generally, it is possible to conclude that facebook has both positive and negative effects on Ethiopian university students’ socio-politics, which seek attention to create awareness among university students in order to exploit the fruits of facebook absolutely and reduce its negative impacts.

Constructing a validated scale to measure community-level abortion stigma in Mexico

In sub-Saharan Africa, the number of maternal deaths due to unsafe abortions has been gradually rising. In Ethiopia, unplanned pregnancies contribute to 25% of births, accounting for 6%-9% of the maternal deaths resulting from unsafe abortions. Despite several disjointed cross-sectional studies that have been carried out in the past, there is no comprehensive data on the attitudes of healthcare practitioners and other related aspects regarding safe abortion in Ethiopia. This study attempted to measure pooled health care providers' attitudes and determinants of safe abortion in Ethiopia. African Journals Online, Medline/PubMed, EMBASE, Science Direct, Hinari, and Google Scholar were the databases that were accessed. The studies were evaluated critically by using the Joanna Briggs Critical Appraisal methods. The study followed the recommendations set forth by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Data were extracted in an Excel spreadsheet and imported to STATA versions 17 software for meta-analysis. The random- effects model was used to pooled the health care providers' attitudes toward safe abortion. Heterogeneity between studies was evaluated using the Cochrane Q-test and I2 statistics (I squared statistics). To evaluate publication bias, egger's tests and funnel plots were employed. Forest plot was used to present the odds ratio (OR) with a 95% confidence interval. In this review and meta-analysis, a total of eight papers with a 2,826 sample size were considered. Overall, 65.49% of Ethiopian health care professionals had a positive attitude towards safe abortion (95%CI: 49.64, 81.34; I2 = 99.20%, P = 0.000). Knowledge of the abortion law (OR = 2.25, 95% CI: 1.06, 3.43), being a male provider (OR = 1.89, 95% CI: 1.23, 2.54), receiving training on abortion (OR = 2.91, 95% CI: 1.17, 4.65), working as a midwife (OR = 3.029, 95% CI: 1.605, 4.453) and practicing abortion procedures (OR = 2.55, 95% CI: 1.32, 3.78) were positively associated with the attitudes of the providers regarding safe abortion in Ethiopia. In Ethiopia, there was a low pooled prevalence of positive attitude towards safe abortion. Safe abortion services in Ethiopia are more likely to be viewed favorably by health care professionals who have received abortion service training and are familiar with abortion laws. As a result, it is imperative that all healthcare facilities and other relevant parties ensure that health professionals receive training on safe abortion services and are aware of Ethiopia's abortion laws.

Ghana amended its abortion law to permit abortion under certain circumstances due to the impacts of unsafe abortion. Even though the abortion law in Ghana is liberal, most women do not utilize the services. Studies have shown that lack of knowledge and attitude towards abortion laws are the barriers deterring women from using safe abortion services. This study, therefore, assessed the knowledge and attitudes of future female health professionals towards Ghana’s abortion law. This was an institutional-based cross-sectional study among 240 female students undertaking undergraduate courses at the Fred Newton Binka School of Public Health (FNBSPH), the University of Health and Allied Sciences (UHAS), Ghana. Knowledge was measured with 9 items using yes or no responses while Attitude was measured using a five-point Likert scale with 14 items. Factors associated with poor knowledge among the students were determined using logistic regression. All analyses were done using STATA version 16.0. Of the 240 participants, 24 (10%) reported ever being pregnant. Among these pregnancies, 20 (83.3%) ended in abortions, with 15 (75%) of them unsafely done. The majority (53.3%) of the students knew the conditions under which abortion is allowed in Ghana and most (61.7%) of them had positive attitudes towards the abortion legislation in the country. The year of study (aOR: 0.06; 95%CI: 0.01–0.23), residential status (aOR: 0.44; 95%CI: 0.20–0.74) and poor attitude towards the abortion law (Aor:0.46; 95% CI: 0.26–0.82) were associated with poor abortion law knowledge among the students. This study has demonstrated that knowledge and attitude towards Ghana’s abortion legislation among the students was fairly good. Students’ year of study, residential status and attitude towards the abortion law were also found associated with poor knowledge of Ghana’s abortion law. Increasing young women’s knowledge of the abortion law may lead to more favourable attitudes towards abortion, improving the utilization of safe and legal abortion services.

IntroductionThe Zambian Termination of Pregnancy Act permits abortion on socio-economic grounds, but access to safe abortion services is limited and this constitutes a considerable problem for rights to sexual and reproductive health. The case of Zambia provides an opportunity to explore the relationship between a legal framework that permits abortion on diverse grounds, the moral and political disputes around abortion and access to sexual and reproductive health services.MethodsThis paper draws upon eleven months of ethnographic fieldwork in Zambia. The fieldwork included 28 open-ended interviews with key stakeholders as well as the collection of archival material related to the origins of Zambia’s legal framework for abortion. The archival material and the interview data were analyzed thematically, using theoretical perspectives on discourse and the anthropology of policies.ResultsThe study findings show that the Zambian case is not easily placed into standard categories of liberal or restrictive abortion laws. The archival material reveals that restrictive elements were in focus when the Zambian Termination of Pregnancy Act was passed (1972). The restrictive aspects of the law were emphasized further when Zambia was later declared as a Christian nation. Some of these restrictive elements are still readily recognized in today’s abortion debate. Currently there are multiple opinions on whether Zambian abortion policy is liberal, restrictive or neither. The law emerges as ambiguous, and this ambiguity is actively used by both those working to increase access to safe and legal abortion services, and those who work to limit such access. Coupled with a lack of knowledge about the law, its ambiguity may work to reduce access to safe abortion services on the grounds permitted by the law.ConclusionsWe argue that the Zambian Termination of Pregnancy Act is ambiguous and leaves much room for interpretation. This paper challenges the notion that the Zambian abortion law is liberal and opens up for further discussion on the relationship between how a law is described and perceived by the public, and the rights to health and services ensured by it.