Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Glob Public Health. 2011;6 Suppl 1(0 1):S1-24. doi: 10.1080/17441692.2011.597413. Epub 2011 Jul 14.
Why is induced abortion common in environments in which modern contraception is readily available? This study analyses qualitative data collected from focus group discussions and in-depth interviews with women and men from low-income areas in five countries--the United States, Nigeria, Pakistan, Peru and Mexico--to better understand how couples manage their pregnancy risk. Across all settings, women and men rarely weigh the advantages and disadvantages of contraception and abortion before beginning a sexual relationship or engaging in sexual intercourse. Contraception is viewed independently of abortion, and the two are linked only when the former is invoked as a preferred means to avoiding repeat abortion. For women, contraceptive methods are viewed as suspect because of perceived side effects, while abortion experience, often at significant personal risk to them, raises the spectre of social stigma and motivates better practice of contraception. In all settings, male partners figure importantly in pregnancy decisions and management. Although there are inherent study limitations of small sample sizes, the narratives reveal psychosocial barriers to effective contraceptive use and identify nodal points in pregnancy decision-making that can structure future investigations.
为什么在现代避孕措施易于获得的环境中，人工流产仍然很常见？本研究分析了来自美国、尼日利亚、巴基斯坦、秘鲁和墨西哥五个国家低收入地区的妇女和男子的焦点小组讨论和深入访谈中收集的定性数据，以更好地了解夫妻如何管理怀孕风险。在所有环境中，在开始性关系或性交之前，妇女和男子很少权衡避孕和堕胎的利弊。避孕与堕胎是分开考虑的，只有当前者被视为避免重复堕胎的首选方法时，两者才会联系在一起。对妇女来说，避孕方法因其潜在的副作用而受到怀疑，而堕胎经历（往往使她们冒着巨大的个人风险）则引发了社会耻辱的阴影，并促使她们更好地使用避孕措施。在所有环境中，男性伴侣在怀孕决策和管理中起着重要作用。尽管存在样本量小的固有研究局限性，但这些叙述揭示了有效避孕措施使用的心理社会障碍，并确定了怀孕决策中的关键点，这些关键点可以为未来的研究提供结构。
