Exploring stigma and social norms in women’s abortion experiences and their expectations of care 

Makleff S, Wilkins R, Wachsmann H, Gupta D, Wachira M, Bunde W, Radhakrishnan U, Cislaghi B, Baum SE. 

In this study, we show how women having abortions in Kenya and India have quite similar fears and expectations for their abortion service, despite major differences in the legal and social contexts in the two countries. In Kenya, abortion is permitted under limited conditions, and there are many barriers to access, including confusion about whether abortion is actually legal. In India, abortion is legal and accessible up to 20 weeks of gestation with few restrictions, though many women still access care outside the formal health system. In both these settings, we found that women arrived for their abortion with little accurate knowledge, negative attitudes towards abortion, fears about the safety and side effects, concerns about being judged, and low expectations for how they would be treated during their abortion. Younger women in both countries expressed particularly strong concerns about abortion safety, potentially because they were scared to look for information or support. Our findings suggest that young women (particularly in Kenya) and unmarried women (particularly in India) are more likely to experience abortion stigma. We propose that clinics in both countries could develop strategies to promote access to youth-friendly services and consider how to reduce experiences of abortion stigma and improve women’s expectations of abortion services – this would ultimately help improve client-centered care.

2019

Sexual and Reproductive Health Matters, https://doi.org/10.1080/26410397.2019.1661753