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New research demystifies abortion practices in Kenya and Benin

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2 March 2022 Tags: Benin, Kenya, research, Safe abortion, She makes her safe choice

Recently published research on abortion practices in Kenya and Benin has provided important insights into how access to information as well as gender-based violence influence the abortion decision-making process of young women. The findings have already contributed to increased awareness and publicity on the issue in both countries amongst journalists, young activists, midwives, and doctors.

While there is increasing research on the drivers of abortion, few studies have looked further. A recent qualitative study by Rutgers conducted with APHRC and ABPF in Kenya (download your copy) and Benin (download your copy) looked specifically at four under-researched factors influencing abortion decision making by girls and young women. They also looked at how these influence the search for abortion services and how they dealt with any abortion complications.

“While we knew what we wanted to research from the start and in which regions in Kenya and Benin, because of our ethnographic approach, new questions popped up along the way that provided important insights,” says Rutgers researcher Jonna Both.

It was exactly those new avenues of enquiry that provided the most interesting results. These strengthened the researchers’ conviction that the findings could indeed have an impact on improving access to safe abortion in Kenya and Benin.

The role of men and mothers in abortion choices

“From the start we knew we wanted to delve further into the role that men (partners or male relatives) played in abortion decision making and the choice of abortion method (safe versus unsafe). However, during our research we found out that it is also really important to understand the role of mothers better. They can be deeply involved in their daughters’ decision making around unintended pregnancies and choice of abortion method.” Jonna explained.

“One of the reasons they are closely involved is to prevent the stigma related to unintended pregnancies for themselves and their daughters. Women are often punished and shamed when their daughter falls pregnant outside of marriage. They run the risk of being send away by their husbands or being subjected to violence. Yet most often they do not have access to a lot of resources, or the network needed to access safe abortion services, hence they offer their daughters homemade brews to abort, which often leads to complications. We also found out that when men (boyfriend, lover, father) were involved in the abortion decision making young women would be more likely to have access to safe methods, as men tended to bring along more financial resources and a larger network, hence they would know a health worker or a clinic that could provide abortion.”

Gender-based violence drives unintended pregnancies

“The research found that rape and incest play an important role in unintended pregnancies, especially in Kilifi County, Kenya. Even though there are laws and guidelines that should allow women access to safe abortion under these circumstances, it was very hard for women and girls to access safe abortion services after rape. Girls and young women would rather resort to unsafe abortion, with all the risks implied.” Said Jonna.

“In Kenya, the issue of sexual and gender-based violence really stood out more. Which is remarkable because abortion is usually a hidden process because of legal frameworks and the stigma attached. Yet in this research because – of the ethnographic approach – we were able to see and gain more insights on how violence unfolds and is a driver for unplanned pregnancy but also plays a role in the decision making and the care-seeking.” Says Ramatou Ouedraogo, Researcher at APHRC.

Different perceptions on safe and unsafe abortion

What also came up during the study was the perception women have about what is considered safe and unsafe abortion, as Ramatou explains: “Women and their relatives have a certain perception of safe abortion: safe abortion is carried out secretly, without facing any stigma; without anyone finding out and condemning them. Therefore, they consider traditional abortion methods -such as homebrews – as safe. However, it is actually ‘social safety’ that guides their decisions as opposed to ‘medical safety’. Understanding these differences of perception can help the people involved in interventions to shape their messages better to bridge the gap.”

There are also still many barriers for young women and girls in both countries to receive non-judgmental (post) abortion care and there is a lot of room for improvement of post-abortion contraceptive counselling to prevent repeat unintended pregnancies and abortion.

Research findings open eyes in Kenya and Benin

“I am really proud that we were able to attract the attention of national media in both Kenya and Benin for our work. In Benin, the research team was invited to a health-focused programme on national radio. In both countries when we invited health care workers, young peer educators and journalists to talk about our findings midwives, doctors, journalists, health care workers shared their personal commitments to reduce the vulnerability of girls and women to unsafe abortion based on the study findings and recommendations.”

“From a journalist in Benin committing to keep the conversation going on the importance of comprehensive sexuality education and another calling out to other journalists to demystify abortion through media accessible to young people, to a health care worker in Kenya promising to share the research findings with community elders and religious leaders, it was all really inspiring,” says Ramatou.

“The results are important too, especially youth activists, NGOs and national, county, and local governments and health workers. By disseminating the data at different platforms and in different forms and organising follow-up conversations we hope that they become (and we have seen this happening already) inspired and motivated to improve their services, health-sector management, programmes. In the long run, these results are important to girls and young women with unintended pregnancies, who will hopefully benefit from better services, from more knowledge and information and from more legal protection,” concludes Jonna.

Young researchers are driving force behind study

Young researchers were engaged in every step of the research, from data collection to analyses. The added value was clear from the start. “Within APHRC we do work often with young people to collect data, but the contribution young people have on analysing the data was astonishing. Together we were able to delve deeper into the data with them which brought out additional information that we would have missed without them,” says Ramatou.

Jonna agrees “They did an amazing job in engaging, and often befriending the girls and young women close to their age going through difficult circumstances. They were able to collect good quality data with them and in the health centres. It was an absolute privilege to work with the eight young researchers in our teams in Benin and Kenya.”

Jonna Both

Jonna conducts research on topics related to safe abortion and gender-based violence prevention. She also advises on planning, monitoring and evaluation in several Rutgers programmes.

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