Lived Experiences of Women Who Underwent Induced Abortion: A qualitative study of Rakai District, Uganda

 
 
 
  • Abstract
  • Keywords
  • References
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  • Abstract


    Background: Induced abortion is one where products of conception are expelled before 28 weeks of gestation. The process can be safe or unsafe. Safe termination of pregnancy is performed by skilled persons using appropriate tools whereas unsafe induced abortion is performed either by persons without the necessary skills or in an environment without the minimum medical standards, or both.

    Objectives: To explore the lived experiences of women who had induced abortion in Rakai District

    Methodology: Phenomenological qualitative design was used. Study population was women who underwent induced abortion. 25 women who had induced abortions in past 1-3years were interviewed. Data was collected by in-depth interviews, tape recorded; transcribed verbatim and written in note book.

    Results: Lived experiences included denial, shame, confusion, fear, anger, anxiety, depression and uncertainty. Participants reported use of local herbs like “ekiwoko” and “majaani”, “etwaata”, “kisuula” and roots of sugar canes, among others, to induce abortion. The processes were mostly traditional, associated with: severe pain, heavy bleeding, and so on. They were life-threatening and horrible. Short- and long-term lived experiences included secondary barrenness, depression, crying-in-privacy and regrets, among others.

    Conclusion: Health workers and women in child-bearing age need to work together to discuss how to control unplanned pregnancies.

     


  • Keywords


    Lived Experiences; Induced Abortion; Quality of Care

  • References


      [1] Alex, L., &Hammarström, A. (2004). Women's experiences in connection with induced abortion - a feminist perspective. Scandinavian Journal of Caring Services, 18 (2): 160-168. https://doi.org/10.1111/j.1471-6712.2004.00257.x.

      [2] Allanson, S. (2007). Abortion decision and ambivalence: Insights via an abortion decision balance sheet. Clinical Psychologist, 11(2), 50-60.https://doi.org/10.1080/13284200701675767.

      [3] Academy of Medical Royal Colleges (AMRC). (2011).Induced Abortion and Mental Health — A Systematic Review of the Mental Health Outcomes of Induced Abortion, Including Their Prevalence and Associated Factors. London: Author.

      [4] Andrews, J. & Boyle, J. (2013). African American Adolescents' Experiences with Unplanned Pregnancy and Elective Abortion. Health Care for Women International, 24 (5): 414-433https://doi.org/10.1080/07399330303995.

      [5] Appiah-Agyekum, N N, 2014. Abortions in Ghana: experiences of university students. Health Science Journal, 8 (4). pp. 531-540

      [6] Astbury-Ward, E.(2008). Emotional and psychological impact of abortion: a critique of the literature. ©FSRH J FamPlannReprod Health Care 2008: 34(3). https://doi.org/10.1783/147118908784734954.

      [7] Atuyambe, L., Mirembe, F., Johansson, A., Kirumira, E.K.,& Faxlid, E. (2005).Experiences of pregnant adolescents-voices from Wakiso distrit, Uganda.African Health Sciences, 2005. pp. 5(4), 304-9.

      [8] Bankole, A., Adewole,I, F., Hussain, H., Awolude, O., Singh, S. &Akinyemi, J. O.(2015).The Incidence of Abortion in Nigeria. International Perspectives on sexual and reproductive health, 41(4): 170 – 181.https://doi.org/10.1363/intsexrephea.41.4.0170.

      [9] Barnard, C.(1990). The Long-Term Psychological Effects of Abortion. Institute for Pregnancy Loss. Portsmouth, N.H

      [10] Bellieni, C. V. &Buonocore, G.(2013). Abortion and subsequent mental health: Review of the literature. Psychiatry ClinNeurosci, 67: 301–310. https://doi.org/10.1111/pcn.12067.

      [11] Bender, S. S., &Geirrson, R.T.(2004). Effectiveness of preabortion counseling on postabortion contraceptive use. Contraception, 69(6), 481-487. https://doi.org/10.1016/j.contraception.2003.12.014.

      [12] Bennett, L.R.(2001). Single women's experiences of premarital pregnancy and induced abortion in Lombok, Eastern Indonesia. Reproductive Health Matters. 2001, 9 (17): 37-43. https://doi.org/10.1016/S0968-8080(01)90006-0.

      [13] Bianchi,D.F.,Perrin,E., Bianchia,P.,Dumont, P.,Lüdicke, F.&Campana, A. (2003). Contraceptive practice before and after termination of pregnancy: a prospective study. Contraception, 67(2), 107–113. https://doi.org/10.1016/S0010-7824(02)00475-4.

      [14] Boemer,M.R.,&Mariutti,M.G.(2010). A woman’s Experiences of Abortion: A qualitative study. Rev Esc Enferm USP.; 37(2):59-71. https://doi.org/10.1590/S0080-62342003000200008.

      [15] Bradshaw, Z., & Slade, P. (2003). The Effects of Included Abortion on Emotional Experiences and Relationships: A Critical Review of the Literature. Clinical Psychology Review, 23(7), 929-958. https://doi.org/10.1016/j.cpr.2003.09.001.

      [16] Bradshaw, Z., & Slade, P. (2005). The relationships between induced abortion, attitudes towards sexuality and sexual problems. Sexual and Relationship Therapy, 20(4), 391-406. https://doi.org/10.1080/14681990500228548.

      [17] Bradshaw, Z. & Slade, P. (2009). The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clinical Psychology Review 23(7):929-58. https://doi.org/10.1016/j.cpr.2003.09.001.

      [18] Broen, A. N.,Moum, T., Bödtker, A. S., &Ekeberg, Ö. (2005b). Reasons for induced abortion and their relation to women's emotional distress: A prospective, two-year follow-up study. General Hospital Psychiatry, 27(1), 36-43. https://doi.org/10.1016/j.genhosppsych.2004.09.009.

      [19] Brown et al. (1993). Prolonged grieving after abortion; a descriptive study. Journal of Clinical Ethics, 4 (2), 118-23 p 120

      [20] Burke, K. T.(1994). Abortion and Post Traumatic Stress Disorder: The Evidence Keeps Piling Up. . 1994.

      [21] Carvalho, G.M., Merighi, M.A.B., Jesus, M.C.P.(2010). The experience of repeated fatherhood during adolescence. Midwifery.2010;26:469.74https://doi.org/10.1016/j.midw.2008.10.007.

      [22] Center for Reproductive Rights. (2012). Briefing paper a technical guide to understanding the legal and policy framework on termination of pregnancy in Mainland Tanzania.

      [23] Colman, S., & Joyce, T. (2011). Regulating abortion: impact on patients and providers in Texas. J Policy Anal Manage.2011;4:775–97https://doi.org/10.1002/pam.20603.

      [24] Cozzarelli, C., Major, B., Karrasch, A., &Fuegen, K. (2000). Women's experiences of and reactions to antiabortion picketing. Basic and Applied Social Psychology, 22(4), 265-275. https://doi.org/10.1207/S15324834BASP2204_1.

      [25] Center for Reproductive Rights (CRR). (2011).10 key points about Uganda's laws and policies on termination of pregnancy. New York : Author

      [26] Center for Reproductive Rights (CRR). ( 2012). Abortion and the law in Uganda, Q&A,. New York : Author

      [27] Dennis, A, Henshaw, S.K., Joyce, T.J., Finer, L.B., Blanchard, K.(2009). The impact of laws requiring parental involvement for abortion: a literature review. New York: Guttmacher.

      [28] Dias, T.Z., Passini, R., Duarte, G.A., Sousa, M.H., Faúndes, A.(2014). Association between educational level and access to safe abortion in a Brazilian population. Int J Gynecol Obstet.; 128(3):224-7 https://doi.org/10.1016/j.ijgo.2014.09.031.

      [29] Dykes K, Slade, P.,&Haywood, A.(2011).Long term follow‐up of emotional experiences after termination of pregnancy: women’s views at menopause.Journal of Reproductive and Infant Psychology. 29(1) 2011. https://doi.org/10.1080/02646838.2010.513046.

      [30] Elliot Institute (2009). Abortion Risks: A list of major psychological complications related to abortion.

      [31] Elul, B., Pearlman, E., Sorhaindo, A., Simonds, W., Westhoff, C.(2000). In-depth Interviews with Medical Abortion Clients: Thoughts on the Method and Home Administration of Misoprostol. J Am Med Womens Assoc. 2000, 55 (3 Suppl): 169-172.

      [32] Ertelt, S. (2010). Recent Studies Confirm Women Face Depression After Abortion, Other Problems LifeNews.com Editor. September 28, 2010. Washington, DC (LifeNews.com)

      [33] Everett, Koop,C. (1987).The Surgeon General’s Report on the Public Health Effects of Abortion. 1987.

      [34] Fergusson, D. M., Boden, J. M., &Horwood, L. J. (2007). Abortion among young women and subsequent life outcomes. Perspectives on Sexual and Reproductive Health, 39(1), 6–12. https://doi.org/10.1363/3900607.

      [35] Fergusson, D.M., Horwood, L.J., Boden, J. M. (2009). Reactions to abortion and subsequent mental health. The British Journal of Psychiatry, 195 (5) 420-426.https://doi.org/10.1192/bjp.bp.109.066068.

      [36] Fielding, S.L., Edmunds, E., &Schaff, E.A.(2002). Having an Abortion Using Mifepristone and Home Misoprostol: A Qualitative Analysis of Women's Experiences. Perspectives on Sexual and Reproductive Health. 34 (1): 34-40. https://doi.org/10.2307/3030230.

      [37] Finer, L. B., Frohwirth, L. F., Dauphinee, L. A., Singh, S., & Moore, A. M. (2005). Reasons U.S. women have abortions: Quantitative and qualitative perspectives. Perspectives on Sexual and Reproductive Health, 37(3), 110-118. https://doi.org/10.1363/3711005.

      [38] Finlay, L.(2011). Interpretative Phenomenological Analysis,in Phenomelogy for Therapist: Researching the lived World. Chichester, UK : John Wiley & Sons

      [39] Fuentes, L., Lebenkoff, S., White, K., Gerdts, C., Hopkins, K., Potter, J. E., & Grossman, D. (2016). Women’s experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas,.Contraception, 93(4), 292–297https://doi.org/10.1016/j.contraception.2015.12.017.

      [40] Gan C, Zou Y, Wu S, Li Y, Liu Q (2008). The influence of medical abortion compared with surgical abortion on subsequent pregnancy outcome. Int J GynaecolObstet2008;101:231–8.https://doi.org/10.1016/j.ijgo.2007.12.009.

      [41] Geller, P.A., Psaros, C., Kornfield, S.L.(2010).Satisfaction with pregnancy loss aftercare: Are women getting what they want?Arch. WomensMent. Health2010; 13: 111124.https://doi.org/10.1007/s00737-010-0147-5.

      [42] Ghosh, S., Acharya, R., Kalyanwala, S., Jejeebhoy, S. (2008). Understanding client satisfaction: Does quality of care matter? Findings from Maharashtra and Rajasthan. Development Studies, Institute of Development Studies Kolkata, Kolkata, Youth and Adolescent Health, Population Council, New Delhi, India, GHF2008.

      [43] Gravensteen, I. K., Helgadóttir, L.B., Jacobsen, E., Rådestad, I., Sandset, P.,&Ekeberg, O. (2013). Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study. https://doi.org/10.1136/bmjopen-2013-003323.

      [44] Grossman, D., Baum, S., Fuentes, L., White, K., Hopkins, K., Stevenson, A.(2014). Change in abortion services after implementation of a restrictive law in Texas. Contraception. 2014;90:496–501https://doi.org/10.1016/j.contraception.2014.07.006.

      [45] Halldén, B.M., Christensson, K., Olsson, P.(2005).Meanings of Being Pregnant and Having Decided on Abortion: Young Swedish Women's Experiences. Health Care for Women International. 2005, 26 (9): 788-806. https://doi.org/10.1080/07399330500230961.

      [46] Harden, A., Ogden, J.(1999). Young women's experiences of arranging and having abortions. Sociology of Health and Illness. 1999, 21 (4): 426-444. https://doi.org/10.1111/1467-9566.00165.

      [47] Helgeson, V. S., Reynolds, K. A., &Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797-816. https://doi.org/10.1037/0022-006X.74.5.797.

      [48] Hemmerling, A, Siedentopf, F., Kentenich, H.(2005). Emotional impact and accessibility of medical abortion with mifepristone: a German experience. J PsychosomObstetGynaecol2005; 26: 23–31.https://doi.org/10.1080/01443610400023056.

      [49] Henshaw, S.W.,|& Kost, K. (2008). Trends in the characteristics of women obtaining abortions. New York,US : Guttmacher,org.

      [50] Hessini, L. (2014) . A Learning Agenda for Abortion Stigma: Recommendations from the Bellagio Expert Group Meeting. s.l. : Women Health, 2014. pp. 54 (7), 617-21.https://doi.org/10.1080/03630242.2014.919987.

      [51] Johnson, B.,& Christenssen, L.(2008). Educatuion Research: Quantitative, Qualitative, and mixed Approaches,3rd ED.Thousand Oaks,CA: Sage Publication

      [52] Jones, Rachel, K., & Jerman, Jenna (2014). Abortion Incidence and Service Availability in the United States, 2011.” Perspectives on Sexual and Reproductive Health. 2014. p. 46(1).https://doi.org/10.1363/46e0414.

      [53] Joyce, T.J., Henshaw, S.K., Dennis, A., Finer, L.B., Blanchard, K.(2009). The impact of state mandatory counseling and waiting period laws on abortion: a literature review. New York: Guttmacher Institute

      [54] Kassebaum, N.J., Bertozzi-Villa, A., Coggeshall, M.S., Shackelford, K.A., Steiner, C., HeutonKR.(2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 13;384(9947):980–1004.

      [55] Kate Cockrill, K.,& Hessini, L. (2014). Introduction: Bringing Abortion Stigma into Focus.Women Health, 2014. pp. 54(7) :593-8.https://doi.org/10.1080/03630242.2014.947218.

      [56] Keogh, S.C., Kimaro, G., Muganyizi, P., Philbin, J., Kahwa, A., Ngadaya, E. (2015). Incidence of Induced Abortion and Post-Abortion Care in Tanzania. PLoS ONE 10(9)https://doi.org/10.1371/journal.pone.0133933.

      [57] Kero, A., Högberg, U., &Lalos, A.(2004). Wellbeing and mental growth—long-term effects of legal abortion. SocSci Med. 2004, 58 (12): 2559-2569. https://doi.org/10.1016/j.socscimed.2003.09.004.

      [58] Kersting, A., Kroker, K., &Steinhard (2009).Psychological impact on women after second and third trimester termination of pregnancy due to fetal anomalies versus women after preterm birth: A 14-month follow up study. Arch. WomensMent. Health2009; 12: 193201.https://doi.org/10.1007/s00737-009-0063-8.

      [59] Khan, S., Bradley, S., Fishel, J., & Mishra, V.(2008).Unmet Need and Demand for Family Planning in Unganda: Further Analysis of the Uganda Demographic and Health Surveys, 1995-2006. Calverton, Maryland,USA : Macro International Inc.

      [60] Kidist, D.(2015). Exploring Women’s Socio-Emotional Experiences of Induced Abortion in Marie Stopes Ethiopia. MA Thesis submitted, Addis Ababa University.

      [61] Knowles, J.,&Chesler, E. (2009).Margaret Sanger — 20th Century HeroWashington, DC: 202-973-4848

      [62] Kumar, U., Baraitser, P., Morton, S.,&Massil, H.(2004). Decision making and referral prior to abortion: a qualitative study of women's experiences. Journal of Family Planning and Reproductive Health Care, 30 (1): 51-54. https://doi.org/10.1783/147118904322702009.

      [63] Lafaurie, M.M., Grossman, D., Troncoso, E., Billings,D.L., Cháveze, S.(2005). Women's Perspectives on Medical Abortion in Mexico, Colombia, Ecuador and Peru: A Qualitative Study .Reproductive Health Matters. 2005, 13 (26): 75-83. https://doi.org/10.1016/S0968-8080(05)26199-2.

      [64] Larsson, S., Eliasson, M., KlingbergAllvin, M., Faxelid, E., Atuyambe, L., Fritzell, S.(2015). The discourses on induced abortion in Ugandan daily newspapers: a discourse analysis. Reproductive Health; 12:58. https://doi.org/10.1186/s12978-015-0049-0.

      [65] Lee, E., Clements, S., Ingham, R., & Stone, N.(2004). A matter of choice? Explaining national variations in teenage abortion and motherhood. New York: Joseph Rowntree Foundation

      [66] Lema, V.M.(2005). Maternal mortality at the Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi, East African Medical Journal, 2005, 82(1):3–9.https://doi.org/10.4314/eamj.v82i1.9286.

      [67] Levandowski, B.A., Mhango, C., Kuchingal, E., Lunguzi, J.,Katengeza, H., Gebreselassie,H., &Singh, S. (2013). The Incidence of Induced Abortion in Malawi. International Perspectives on Sexual and Reproductive Health, 39(2),Pages 88 - 96 https://doi.org/10.1363/3908813.

      [68] Lie, M. L., Robson, S.C. & May, C.R.(2008). Experiences of abortion: A narrative review of qualitative studies. BMC Health Services Research,20088:150. https://doi.org/10.1186/1472-6963-8-150.

      [69] Lunneborg, P. W. (1992). Abortion: A Positive Decision. New York: Bergin & Garvey.

      [70] Maina., B.W., Mutua, M.M.,&Sidze, E. M (2015). Factors associated with repeat induced abortion in Kenya. BMC Public Health,201515:1048. https://doi.org/10.1186/s12889-015-2400-3.

      [71] Major, B. ,&Gramzow, R. H. (1999). Abortion as stigma: Cognitive and emotional implications of concealment. Journal of Personality and Social Psychology, 77(4), 735-745. https://doi.org/10.1037/0022-3514.77.4.735.

      [72] Major, B., Appelbaum, M., Beckman, L., Dutton, M. A., Russo, N. F., & West, C. (2009). Abortion and mental health: Evaluating the evidence. American Psychologist, 64(9), 863-890. https://doi.org/10.1037/a0017497.

      [73] Major, B., &Cozzarelli, C. (1992). Psychosocial predictors of adjustment to abortion. Journal of Social Issues, 48(3), 121–142. https://doi.org/10.1111/j.1540-4560.1992.tb00900.x.

      [74] Major, B., Cozzarelli, C., Cooper, M. L., Zubek, J., Richards, C., Wilhite, M., &Gramzow, R. H. (2000). Psychological responses of women after first-trimester abortion. Archives of General Psychiatry, 57(8), 777-784. https://doi.org/10.1001/archpsyc.57.8.777.

      [75] Major, B., Cozzarelli, C., Sciacchitano, A. M., Cooper, M. L., Testa, M., & Mueller, P. M. (1990). Perceived social support, self-efficacy, and adjustment to abortion. Journal of Personality and Social Psychology, 59(3), 452-463. https://doi.org/10.1037/0022-3514.59.3.452.

      [76] Major, B., Richards, C., Cooper, M. L., Cozzarelli, C., &Zubek, J. (1998). Personal resilience, cognitive appraisals, and coping: An integrative model of adjustment to abortion. Journal of Personality and Social Psychology, 74(3), 735-752. https://doi.org/10.1037/0022-3514.74.3.735.

      [77] Major, B., Zubek, J. M., Cooper, M. L., Cozzarelli, C., & Richards, C. (1997). Mixed messages: Implications of social conflict and social support within close relationships for adjustment to a stressful life event. Journal of Personality and Social Psychology, 72(6), 1349-1363. https://doi.org/10.1037/0022-3514.72.6.1349.

      [78] Major, B.,& Gramzow, R.H. (1999). Abortion as stigma: Cognitive and emotional implications of concealment. s.l. J Pers Soc Psychol, 1999. pp. 77(4), 735-45.https://doi.org/10.1037/0022-3514.77.4.735.

      [79] Major, B. & O'Brien, L.T.(2005).The social psychology of stigma. s.l. : Annu Rev Psychol, 2005. pp. 56: 393-421.https://doi.org/10.1146/annurev.psych.56.091103.070137.

      [80] Mann, J. R., McKeown, R.E., Bacon, J., Vesselinov, R., Bush, F.(2008).Predicting depressive symptoms and grief after pregnancy loss. J. Psychosom. Obstet. Gynaecol.2008; 29: 274279.https://doi.org/10.1080/01674820802015366.

      [81] Margaret Sanger (1879–1966).Woman and the New Race, Women’s Struggle for Freedom,1920.

      [82] Mariutti, M.G., Furegato, A.R.F. (2010). Factors affecting rates of depression among women who have undergone induced abortion. Rev Bras Enferm, 63(2):183-9. https://doi.org/10.1590/S0034-71672010000200003.

      [83] McIntyre, M., Anderson, B., McDonald, C.(2001). The Intersection of Relational and Cultural Narratives: Women's Abortion Experiences. Canadian Journal of Nursing Research, 33(3): 47-62.

      [84] Melo, F.R.M., Lima, M.S., Alencar, C.H. Jr, ANR, Costa, F.H., Machado, M.M.T, Heukelbach, J. (2014).Temporal trends and spatial distribution of unsafe abortion in Brazil.RevSaúdePública. 1996-2012.

      [85] Mohamed ,S.F., Izugbara, C, Moore, A.M (2015). The estimated incidence of induced abortion in Kenya: a cross-sectional study. BMC Pregnancy and Childbirth. 2015;15:185. https://doi.org/10.1186/s12884-015-0621-1.

      [86] Munk-Olsen, T.,Laursen, T.M.,Pedersen, C.B., Lidegaard, Ø., Mortensen, P.B.(2011). Induced first-trimester abortion and risk of mental disorder. N. Engl. J. Med.2011; 364: 332–339.https://doi.org/10.1056/NEJMoa0905882.

      [87] Nader, P.R.A, Blandino, VRP.,Maciel, ELN. (2007). Characterístics of abortion among women attneing maternity public helathcentres in Serra - ES. Rev Bras Epidemiol [Internet] 2007 10(4):615-24. Disponívelem: http://www.scielo.br/pdf/rbepid/v10n4/18.pdf .https://doi.org/10.1590/S1415-790X2007000400019.

      [88] Nalwadda, G, Nabukere, S.,& Salihu, H.M. (2005). Theabortion paradox in Uganda: fertility regulator or cause of maternal mortality.s.l. : J Obstet Gynaecol, 2005. pp. 25(8): 776-80.https://doi.org/10.1080/01443610500328074.

      [89] Nalwadda, G., Mirembe, F., Tumwesigye, N.M., Byamugisha, J., & Faxelid, E. (2011).Constraints and prospects for contraceptive service provision to young people in Uganda: provider's perspectives. s.l. BMC Health Serv Res, 2011. p. 11:220.https://doi.org/10.1186/1472-6963-11-220.

      [90] Ndunyu, L.N.(2013). Women’s Experiences of Induced Abortion in Mombasa City and the Kilifi District, Kenya. PhD Thesis, University of KwaZulu-Natal, 2013

      [91] Norris, A., Harrington, B. J., Grossman, D., Hemed, M., &Hindin, M. J. (2016). Abortion experiences among Zanzibari women: a chain-referral sampling study. Reproductive Health, 13, 23. https://doi.org/10.1186/s12978-016-0129-9.

      [92] Pedersen, W.(2008).Abortion and depression: A population-based longitudinal study of young women. Scand. J. Public Health2008; 36: 424–428.https://doi.org/10.1177/1403494807088449.

      [93] Polis, C., Wawer, M.J., Serwadda, D., Nalugoda, F., Kiwanuka, N., Kagaayi, J., Chen, M., Brahmbhatt, H., Gray, R.H.(2009). Effect of Hormonal Contraceptives Use on Time to AIDS or Death in Female HIV Sero-converters in Rakai, Uganda. 16th Conference on Retroviruses and Opportunistic Infections, Montreal, Canada. February 8-11, (Poster).

      [94] Prada, E., Mirembe, F., Ahmed, F.H., Nalwadda, R.,& Kiggundu, C.(2005).Abortion and postabortion care in Uganda:a report from health care proffessionals and health facilities. New York : The Alan Guttmacher Institute, 2005.

      [95] Rakai Health Sciences Program (RHSP), 2010. STATUS REPORT 2010 (2010)

      [96] Rasch ,V., Sørensen, P.H., Wang, A.R., Tibazarwa, F.,Jäger, A.K.(2014). Unsafe abortion in rural Tanzania - the use of traditional medicine from a patient and a provider perspective. BMC Pregnancy Childbirth. 2014;14(1):419. https://doi.org/10.1186/s12884-014-0419-6.

      [97] Rasch, V. (2011).Unsafe abortion and postabortion care-an overview. s.l. : Acta Obstet Gynecol Scand, 2011.https://doi.org/10.1111/j.1600-0412.2011.01165.x.

      [98] Reardon, D.C., & Coleman, P.K. (2006). Relative Treatment Rates for Sleep Disorders and Sleep Disturbances Following Abortion and Childbirth: A Prospective Record Based-Study, Sleep 29(1):105-106, 2006.https://doi.org/10.1093/sleep/29.1.105.

      [99] Reardon, D.C., Cougle, J.R., Rue, V.M., Shuping, M.W., Coleman, P.K., Ney, P.G.(2003)Psychiatric admissions of low-income women following abortion and childbirth. CMAJ2003; 168: 1253–1256.

      [100] Rees, D.I.,&Sabia, J.J. (2007).The relationship between abortion and depression: New evidence from the fragile families and child wellbeing study. Med. Sci. Monit.2007; 13: CR430–CR436.https://doi.org/10.12659/MSM.502357.

      [101] Rehnström, L.U, Gemzell-Danielsson, K, Faxelid, E, Klingberg-Allvin, M. (2015). Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data. BMC Public Health; 15:139. https://doi.org/10.1186/s12889-015-1502-2.

      [102] Reminnick, L., & Segal, R. (2001). Socio-cultural context and women's experiences of abortion: Israeli women and Russian immigrants compared. Culture, Health and Sexuality, 3(1): 49-66. https://doi.org/10.1080/136910501750035671.

      [103] Richards,L.(2005). Handling Qualitative Data.

      [104] Ringheim,K.(1999).Ethical issues in postabortion care research involving vulnerable sublects. In: Huntington D, Piet-Pelon NJ,editors. Postabortion Care: Lessons from Operations Research. New York : The Population, 1999. pp. 178-976.

      [105] Roberts, H., Silva, M., &Xu, S.(2010). Post abortion contraception and its effect on repeat abortions in Auckland, New Zealand. Contraception; 82 (3):260–5.https://doi.org/10.1016/j.contraception.2010.03.003.

      [106] Rocca, C.H., Kimport, K., Roberts, S.C.M., Gould, H., Neuhaus, J., Foster, D.G. (2015). Decision Rightness and Emotional Responses to Abortion in the United States: A Longitudinal Study. Dekel S, ed. PLoS ONE. 2015;10(7):e0128832. https://doi.org/10.1371/journal.pone.0128832.

      [107] Russo, N. F.(2008). Understanding emotional responses after abortion. In J. C. Chrisler, C., Golden &Rozee, P. D. (Eds.), (pp. 173-189). New York, NY, US: McGraw-Hill.

      [108] Say, L., Chou, D., Gemmill, A., Tuncalp, O., Moller, A.B., Daniels, J.(2014).Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014 Jun;2(6):e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X.

      [109] Schutz, A. (1967). The phenomenology of the social world. Evanston, IL: Northwestern University Press

      [110] Sedgh, G. (2010). Abortion in Ghana. Issues in brief. New York: Alan Guttmacher Institute)

      [111] Sedgh, G, Rossier, C., Kabore, I., Bankole, A., Mikulich, M.(2007). Induced abortion: estimated rates and trends worldwide. Lancet; 370(9595):1338–45. https://doi.org/10.1016/S0140-6736(07)61575-X.

      [112] Sell, S.E., Kotzias, E.A., Velho, B.M., Erdmann, A.L., Rodriguez, M.H. (2015). Reasons and meanings attributed by women who experienced induced abortion: an integrative review. Rev. esc. enferm. 49(3). https://doi.org/10.1590/S0080-623420150000300019.

      [113] Shah, I. & Ahman,E.(2009).Unsafe abortion: Global and regional Incidence, Trends,Consequences, and Challenges. s.l. : J Obstet Gynaecol Can, 2009. pp. 31(12),1149-58.https://doi.org/10.1016/S1701-2163(16)34376-6.

      [114] Shellenberg, K.M, Hessini, L. & Levandowski, B.A.(2014). Developing a scale to measure Stigmatizing Attitudes and Beliefs About Women Who Have Abortions:Results from Ghana and Zambia.s.l. : Women Health, 2014. pp. 54(7), 599-616.https://doi.org/10.1080/03630242.2014.919982.

      [115] Silva, R. S. and Vieira, E.M.(2009). Frequency and characteristics of induced abortion among married and singles women in São Paulo, Brazil. Cad SaúdePública, 25(1):179-87. https://doi.org/10.1590/S0102-311X2009000100019.

      [116] Simonds, W., Ellertson, C., Springer, K., Winikoff, B.(1998). Abortion, revised: participants in the U.S. clinical trials evaluate mifepristone. Social Science and Medicine. 1998, 46 (10): 1313-1323. https://doi.org/10.1016/S0277-9536(97)10063-6.

      [117] Singh, S, Sedgh, G.,&Hussain, R.(2010).Unintended Pregnancy: Worlwide Levels, Trends, and Outcomes. s.l. : Stud Fam Plann, 2010. pp. 41(4), 241-50.https://doi.org/10.1111/j.1728-4465.2010.00250.x.

      [118] Singh, S. (2006). Hospital admissions resulting from unsafe abortion: estimates from 13 developing countries. Lancet, 25;368(9550):1887–92. https://doi.org/10.1016/S0140-6736(06)69778-X.

      [119] Singh, S., GuttmacherInstitute;Prada, E.,Mirembe, F., &Kiggundu, C. 2005. The Incidence of Induced Abortion in Uganda. International perspective on sexual and reproductive health, 31(4): 183 – 191https://doi.org/10.1363/3118305.

      [120] Singh, S., Prada, E., Mirembe, F. & Kiggundu, C. (2005).The incidence of induced abortion in Uganda. s.l. : Int Fam Plan Perspective, 2005. pp. 31(4), 183-191.https://doi.org/10.1363/3118305.

      [121] Singh, S., Wulf, D., Hussain, R., Bankole, A. & Sedgh, G.(2009).Abortion Worldwide: A Decade of Uneven Progress. New York : Guttmacher Institute, 2009.

      [122] Smith, J. A., Flowers, P. & Larkin, M.(2009).Interpretative Phenomenological analysis: Theory, Method, and Research. Los Angeles, CA : Sage Publication

      [123] Souza, Z. C. S.&Diniz, N. M. F. (2011). Abortion factors: A discussion of women’s experiences with their families. TextoContexto-Enferm; 20(4):742-750. Disponívelem: http://www.scielo.br/pdf/tce/v20n4/13.pdf. https://doi.org/10.1590/S0104-07072011000400013.

      [124] Steinberg, J. R., & Finer, L. B. (2011). Examining the association of abortion history and current mental health: A re-analysis of the National Co-morbidity Survey using a common-risk-factors model. Social Science & Medicine, 72(1), 72-82. https://doi.org/10.1016/j.socscimed.2010.10.006.

      [125] Steinberg, J. R., & Russo, N. F. (2008). Abortion and anxiety: What's the relationship? Social Science & Medicine, 67(2), 238-252. https://doi.org/10.1016/j.socscimed.2008.03.033.

      [126] Steinberg, J.R.( 2011). Later abortions and mental health.Psychological experiences of women having later abortions-Acritical review research.s.l. : Women's Health Issues, 2011. pp. 21(3), S44-S48.https://doi.org/10.1016/j.whi.2011.02.002.

      [127] Stotland, N.(2001). Psychiatric aspects of induced abortion. Arch Womens Mental Health 2001; 4: 27–31https://doi.org/10.1007/s007370170005.

      [128] Thapa, S., &Neupane, S. (2013). Risk factors for repeat abortion in Nepal. Int J GynecolObstet; 120(1):32–6.https://doi.org/10.1016/j.ijgo.2012.07.016.

      [129] The Royal College of Psychiatrists (2008). Position Statement on Women’s Mental Health in Relation to Induced Abortion, 14 March 2008.

      [130] Ting, T.W., Low, W.Y., Wong, Y.T., Choong, S.P.&Jegasothy, R. (2012). Exploring pregnancy termination experiences and needs among Malaysian women: A qualitative study. BMC Public Health, 12:743. https://doi.org/10.1186/1471-2458-12-743.

      [131] Törnbom, M., &Möller, A.(1999). Repeat abortion: a qualitative study. Journal of Psychosomatic Obstetrics and Gynecology, 20 (1): 21-30. https://doi.org/10.3109/01674829909075573.

      [132] Uganda Bureau of Statistics (UBOS)& ICF International.(2012).Uganda Demographic and Health Survey 2011. Kampala-Uganda, Calverton,MD,USA: Authors

      [133] Upadhyay, U.D., Brown, B.A.,Sokoloff, A. &Raine, T.R.(2012).Contraceptive discontinuation and repeat unintended pregnancy within 1 year after an abortion. Contraception;85(1):56–62.https://doi.org/10.1016/j.contraception.2011.05.009.

      [134] Vilma,E.(2006). The meaning of abortion experience for women.Blekinge Institute of Technology.

      [135] Warren, J.T., Harvey, S.M., Henderson, J.T.(2010).Do depression and low self-esteem follow abortion among adolescents? Evidence from a national study. Perspect. Sex. Reprod. Health2010; 42: 230235.https://doi.org/10.1363/4223010.

      [136] Welter, L. B. (2015).Mexican-American women and abortion: experiences and reflections. PhD (Doctor of Philosophy) thesis, University of Iowa, 2015.

      [137] Worell, J.(2001). Encyclopedia of Women and Gender. Sex similarities and differences and the impact of society on gender. San Diego : Academic Press

      [138] World Health Organization (WHO). (2012). Trends in Maternal Mortality :1990 to 2010. Geneva : Author

      [139] World Health Organisation (WHO). (2011). Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2008, 6th ed. Geneva: Author.


 

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Article ID: 31366
 
DOI: 10.14419/ijh.v8i1.31366




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