Factors Influencing Unsafe Abortion Decision-Making Among Young Women in an Abortion-Restricted Setting

Abstract

Abstract Background Abortion is one of the leading causes of maternal death in low- and middle-income countries. With few African countries legalizing abortion, rates are higher in countries where access to legal abortion is restrictive. Although the act is still regarded as a criminal offense in Namibia, women still find other means and ways to terminate unplanned pregnancies, resulting in unsafe abortions. The study aimed to explore the factors influencing unsafe abortion decision-making among young women in a referral hospital in Namibia. Method The method employed was a qualitative explorative descriptive design. Eleven participants were interviewed face-to-face using the semi-structured interview guide at an Intermediate Hospital female ward. The data was analyzed thematically. Results Our study respondents were young women aged 16 to 24 years. About 66.7% (n = 10) were school-going, while 33.3% (n = 5) dropped out of school. Some of the young women (53.3%; n = 8) had been pregnant before. All our respondents indicated their marital status as single at the time of the study. The analysis yielded four main themes: Understanding the term abortion, interpersonal factors, personal factors, and views on legalizing abortion. The study revealed that influencing factors were strongly personal and interpersonal, including young women’s fear of rejection by their parents and/or the community, lack of support, and desire to pursue education and bear children in marriage. Conclusion Young women’s decisions on abortion are greatly influenced by various internal and external factors. There is an unmet need for abortion on demand among young women in abortion-restricted settings such as Namibia.