Erhardt-Ohren Blake, El Ayadi Alison M, Nalubwama Hadija, Camlin Carol S, Walker Dilys, Byamugisha Josaphat, Tsai Alexander C, Senoga Umar, Krezanoski Paul J, Harper Cynthia C, Comfort Alison B
School of Public Health, University of California Berkeley, Berkeley, California, USA.
Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
J Glob Health. 2025 Apr 11;15:04125. doi: 10.7189/jogh.15.04125.
In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy.
We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregnant women aged ≥18 years at their first antenatal care visit at Kawempe National Referral Hospital in Kampala, Uganda. We conducted the interviews in Luganda or English, transcribed them, and then translated them into English, as needed, for analysis. We analysed the data using thematic analysis. Deductive codes were based on social networks, social support, and health behaviour theories, and inductive codes were derived from interview transcripts.
Almost half of the study participants (n = 13) considered an induced abortion before deciding to continue carrying their pregnancy. The most commonly stated reasons they considered abortion included anticipated interruptions to work and education, exhaustion related to child-rearing, and lack of social support. Other participants (n = 9) reported not considering abortion due to anticipated social support for their pregnancy, concerns about abortion-related morbidity and mortality, late confirmation of pregnancy, and religious beliefs. No participants discussed Uganda's restrictive abortion policies as a reason not to consider abortion.
Our results point to opportunities for continued reproductive health education and improved access to reproductive health services to allow pregnant women to meet their reproductive needs, seek out family planning, antenatal care, and safe abortion services when desired, and create support networks for pregnant women.
在乌干达，只有约一半希望避免怀孕的女性使用现代避孕方法，这导致意外怀孕数量居高不下，孕产妇和新生儿发病率及死亡率上升。在本研究中，我们旨在进一步了解女性在决定继续妊娠前的堕胎决策情况。
我们采用定性研究设计，在乌干达坎帕拉的卡韦姆佩国家转诊医院，对31名年龄≥18岁、在首次产前检查时被有意挑选出的单身及有伴侣的孕妇进行了访谈。我们用卢干达语或英语进行访谈，记录访谈内容，然后根据需要将其翻译成英语进行分析。我们使用主题分析法对数据进行分析。演绎编码基于社会网络、社会支持和健康行为理论，归纳编码则源自访谈记录。
近一半的研究参与者（n = 13）在决定继续妊娠前考虑过人工流产。她们考虑堕胎的最常见原因包括预计工作和教育会受到影响、育儿导致的疲惫以及缺乏社会支持。其他参与者（n = 9）报告称，由于预计会得到对其怀孕的社会支持、担心与堕胎相关的发病率和死亡率、怀孕确认较晚以及宗教信仰，所以没有考虑堕胎。没有参与者将乌干达严格的堕胎政策作为不考虑堕胎的原因进行讨论。
我们的研究结果表明，有机会继续开展生殖健康教育并改善生殖健康服务的可及性，以使孕妇能够满足其生殖需求，在需要时寻求计划生育、产前护理和安全堕胎服务，并为孕妇建立支持网络。
