Cleeve Amanda, Faxelid Elisabeth, Nalwadda Gorette, Klingberg-Allvin Marie
a Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.
b WHO Collaborating Center for Human Reproduction , Karolinska University Hospital , Stockholm , Sweden.
Cult Health Sex. 2017 Nov;19(11):1286-1300. doi: 10.1080/13691058.2017.1310297. Epub 2017 Apr 11.
Unsafe abortion in Africa continues to be a major contributor to the global maternal mortality which affects young women in particular. In Uganda, where abortion is legally restricted and stigmatised, unsafe abortion is a major public health issue. We explored reproductive agency in relation to unsafe abortion among young women seeking post-abortion care. Through in-depth interviews we found that reproductive agency was constrained by gender norms and power imbalances and strongly influenced by stigma. Lack of resources and the need for secrecy resulted in harmful abortion practices and delayed care-seeking. Women did not claim ownership of the abortion decision, but the underlying meaning in the narratives positioned abortion as an agentive action aiming to regain control over one's body and future. Women's experiences shaped contraceptive intentions and discourse, creating a window of opportunity that was often missed. This study provides unique insight into how young women negotiate and enact reproductive agency in Uganda. Health systems need to strengthen their efforts to meet young women's sexual and reproductive health needs and protect their rights. Enabling young women's agency through access to safe abortion and contraception is paramount.
非洲不安全堕胎仍然是全球孕产妇死亡的主要原因，尤其影响年轻女性。在乌干达，堕胎受到法律限制且遭人诟病，不安全堕胎是一个重大的公共卫生问题。我们探讨了寻求堕胎后护理的年轻女性中与不安全堕胎相关的生殖自主权。通过深入访谈，我们发现生殖自主权受到性别规范和权力失衡的限制，并受到耻辱感的强烈影响。资源匮乏和需要保密导致有害的堕胎行为以及延迟寻求护理。女性并未声称对堕胎决定拥有自主权，但叙述中的潜在含义将堕胎定位为旨在重新掌控自己身体和未来的自主行动。女性的经历塑造了避孕意图和话语，创造了一个常常被错过的机会之窗。这项研究为年轻女性在乌干达如何协商和行使生殖自主权提供了独特见解。卫生系统需要加大力度满足年轻女性的性健康和生殖健康需求并保护她们的权利。通过提供安全堕胎和避孕措施来赋予年轻女性自主权至关重要。
