Role-players in abortion decision-making in the Accra Metropolis, Ghana

Reproductive Health

Joshua Amo-Adjei²  Fred Yao Gbagbo¹  Akwasi Kumi-Kyereme² 

[1] Marie-Stopes International, Accra, Ghana;Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Ghana

关键词: Ghana;    Decision-making;    Role-players;    Abortion;   

Others  :  1132340
DOI  :  10.1186/1742-4755-11-70

 received in 2014-02-27, accepted in 2014-09-12,  发布年份 2014

【 摘 要 】

Background

Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana.

Methods

A retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data.

Results

The findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and “Others” (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations.

Conclusion

A number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision.

【 授权许可】

   
2014 Kumi-Kyereme et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Schuster S: Abortion in the moral world of the Cameroon grassfields. Reprod Health Matters 2005, 13:130-138.
• [2]Singh S, Prada E, Mirembe F, Kiggundu C: The incidence of induced abortion in Uganda. Inter Fam Plg Persp 2005, 31(4):183-191.
• [3]Schwandt HM, Creanga AA, Adanu RM, Danso KA, Agbenyega T, Hindin MJ: Pathways to unsafe abortion in Ghana: the role of male partners, women and health care providers. Contraception 2013, 88(4):509-517.
• [4]Bleek W: Avoiding shame: the ethical context of abortion in Ghana. Anthropological Quarterly 1981, 54(4):203-209.
• [5]Alan Guttmacher Institute: Induced Abortion: Incidence and Trends Worldwide from 1995 to 2008. New York, USA: Guttmacher Institute; 2012.
• [6]Manian M: The Irrational Woman: Informed Consent and Abortion Decision-Making. Duke J Gender Law Policy 2009, 16:223.
• [7]World Health Organization: The Prevention and Management of Unsafe Abortion: Report of a Technical Working Group. WHO/MSM/92.5. Geneva: World Health Organisation; 2004.
• [8]Clyde J, Bain J, Castagnaro K, Rueda M, Tatum C, Watson K: Evolving capacity and decision-making in practice: adolescents’ access to legal abortion services in Mexico City. Reprod Health Matters 2013, 21(41):167-175.
• [9]Côté I, Lapierre S: Abortion and domestic violence: women’s decision-making process. Affilia 2014. doi:10.11770886109913519791
• [10]Harden A, Ogden J: Young women’s experiences of arranging and having abortions. Soc Health Illn 1999, 2:426-444.
• [11]Kirkman M, Rowe H, Hardiman A, Rosenthal D: Abortion is a difficult solution to a problem: A discursive analysis of interviews with women considering or undergoing abortion in Australia. Women’s Studies Inter Forum 2011, 34(2):121-129.
• [12]Hull NEH, Hoffer PC: Roe v. Wade: The Abortion Rights Controversy in American History. University Press of Kansas; 2010.
• [13]Ipas: Children, Youth and Unsafe Abortion. Chapel Hill, New York City: Ipas; 2001.
• [14]Dodoo FN, Frost AE: Gender in African Population Research: The Fertility/Reproductive Health Example. Ann Rev Soc 2008, 34:431-452.
• [15]Amo-Adjei J: Age differences and protected first heterosexual intercourse in Ghana: original research article. African J Reprod Health 2012, 16(4):58-67.
• [16]Ebenstein A: Why do Parents Abort Girls? Patrilocality and Its Historical Origins. 2014. https://www.princeton.edu/rpds/events_archive/repository/Ebenstein021214/Ebenstein021214b.pdf webcite, accessed on 2014/06/27
• [17]Darteh EKM, Doku DT, Esia-Donkoh K: Reproductive health decision making among Ghanaian women. Reprod Health 2014, 11:23. doi:10.1186/1742-4755-11-23 BioMed Central Full Text
• [18]Ghana Health Service: Induced Abortion. Reproductive and Child Health Department of the Family Health Division. 2007.
• [19]Ghana Statistical Service, Ghana Health Service, ICF Macro: Ghana Demographic and Health Survey 2008. Accra, Ghana: GSS, GHS, and ICF Macro;
• [20]Blaikie N: Designing Social Research: The Logic of Anticipation. Oxford: Polity Press; 2000.
• [21]Onwuegbuzie AJ, DaRos-Voseles DA: The role of cooperative learning in research methodology courses: a mixed-methods analysis. Res Schools 2001, 8:61-75.
• [22]Nyarko P, Adohinzin C, Ramarao S, Ajayi A: Profile of Abortion Seekers in Ghana and their Decision-Making Processes. New York: Population Council; 2008.
• [23]Pathfinder International Ghana: Community Survey Questionnaire on Knowledge, Attitude, and Practice of Abortion for Women 15–49 Years. 2007.
• [24]Henry R, Fayorsey C: Coping with Pregnancy: Experiences of Adolescents in Ga Mashi, Accra. Calverton, Maryland, USA: Marco; 2002.
• [25]Dean AG, Sullivan KM, Soe MM: OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. http://www.openepi.com/SampleSize/SSPropor.htm webcite, updated 2013/04/06, accessed 2014/06/26
• [26]Veiga MB, Lam M, Gemeinhardt C, Houlihan E, Fitzsimmons BP, Hodgson ZG: Social support in the post-abortion recovery room: evidence from patients, support persons and nurses in a Vancouver clinic. Contraception 2011, 83(3):268-273.
• [27]Adler AJ, Filippi V, Thomas SL, Ronsmans C: Quantifying the global burden of morbidity due to unsafe abortion: magnitude in hospital-based studies and methodological issues. Inter J Gyne Obstetrics 2012, 118:S65-S77.
• [28]Taylor D, Connolly S, Ingles SA, Watson C, Segall-Gutierrez P: Immediate Post-Abortion Insertion of Intrauterine Contraceptives (IUC) in a Diverse Urban Population. J Immigr Minor Health 2014, 16(3):416-421.
• [29]Zemene A, Feleke A, Alemu A, Yitayih G, Fantahun A: Factors Influencing Utilization of Post Abortion Care in Selected Governmental Health Institutions, Addis Ababa. Ethiopia Fam Med Med Sci Res 2014, 3(115):2.
• [30]Browner C: Abortion decision-making: Some findings from Colombia. Stud Fam Planning 1979, 10(3):96-106.
• [31]Gürsoy A: Abortion in Turkey: a matter of state, family or individual decision. Soc Sci Med 1996, 42(4):531-542.
• [32]Moore AM, Jagwe-Wadda G, Bankole A: Men’s attitudes about abortion in Uganda. J Biosocial Science 2011, 43(1):31-45.
• [33]Glander SS, Moore ML, Michielutte R, Parsons LH: The prevalence of domestic violence among women seeking abortion. Gynecol Obstet 1998, 91(6):1002-1006.
• [34]Chibber KS, Biggs MA, Roberts S, Foster DG: The role of intimate partners in women’s reasons for seeking abortion. Womens Health Issues 2014, 24(1):e131-e138.
• [35]Byrnes JP: The Nature and Development of Decision-Making: A Self-Regulation Model. London: Psychology Press [Taylor & Francis Group]; 2013.
• [36]Lee , Clements S, Ingham R, Stone N: A matter of choice? Explaining national variation in teenage abortion and motherhood. York: Joseph Rowntree Foundation; 2004.
• [37]Luke N: Confronting the ’sugar daddy’ stereotype: age and economic asymmetries and risky sexual behavior in urban Kenya. Inter Fam Plg Pers 2005, 31(1):6-14.
• [38]Ralph L, Gould H, Baker A, Foster DG: The role of parents and partners in minors’ decisions to have an abortion and anticipated coping after abortion. J Adoles Health 2014, 54(4):428-434.
• [39]Foster DG, Gould H, Taylor J, Weitz TA: Attitudes and decision making among women seeking abortions at one US clinic. Persp Sex Reprod Health 2012, 44(2):117-124.