Unwanted Pregnancy in Zanzibari Women: Weighing Fears of Abortion against Consequences of Birth

• In Event: 149 - Regular Session. Fertility: Childbearing Decisions, Regrets, and Reassessments

Abstract

Introduction: In settings across sub-Saharan Africa, women experience significant morbidity and mortality from unsafe abortions. Our research addresses a central question for women with an unwanted pregnancy: How do women decide between the risks of keeping an unwanted pregnancy and the risks of having an unsafe abortion?
Methods: We conducted in-depth semi-structured qualitative interviews with 46 Zanzibari women who had had at least one induced abortion. Given the stigmatized and secret nature of abortion, we used snowball sampling to recruit a community-based sample.
Results: While women had significant fears about abortion and believed it to be immoral, they experienced unwanted pregnancies across the reproductive life-span, and our participants feared the consequences of unwanted pregnancy more than they feared abortion. Women made abortion decisions with and without the support of family and partners.
Discussion: Most research about abortion in contexts where abortion is illegal is conducted among post abortion care patients. By interviewing a community-based sample of women who largely had uncomplicated illegal abortions in homes or clinics, we fill a gap in understanding how these women, who were able to access less unsafe abortions, weigh fears of abortion’s health and moral consequences against the fears of continuing an unwanted pregnancy.

Authors

• Maryam Hemed, African Union Commission

• John B. Casterline, The Ohio State University