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TOPIC : Male Partners’ Involvement in Abortion and Uptake of Post-Abortion Family Planning Services

 

ABSTRACT

Male involvement in abortion and post-abortion family planning uptake is pivotal in reducing unintended pregnancies while optimising contraceptive use. While literature is extant with the positive outcomes of men’s role in abortion and contraceptive use, there is insufficient interrogation of the relationship between male partners’ involvement in abortion and post-abortion family planning uptake. This study sought to examine the relationship between male partners’ involvement in abortion and immediate post-abortion contraception uptake. The specific objectives were to: explore the extent of male partners’ participation in abortion; women's expectations of their partners’ roles in the abortion and barriers to partners’ inclusion and participation in abortion.

Using a sequential mixed method approach, data were obtained first through in-depth interviews and observations from women and their male partners, followed by a survey with only women. Data collection was conducted in four purposively selected health facilities in the Greater Accra Region. Thematic analysis was done using the Nvivo software. Multiple logistic regression analysis was performed with SPSS to investigate the relationship between male partners’ involvement in abortion and post-abortion family planning uptake. At the end of the study, 41 interviews were conducted and 356 respondents participated in the survey.

The study found that post-abortion family planning uptake was influenced by communicative and emotional support provided by male partners at the time of the abortion. However, emotional support was inversely related to post-abortion contraception uptake. The woman’s employment, self-efficacy and level of family planning knowledge were significantly associated with post-abortion family planning uptake. Male partners’ educational level, ethnicity and knowledge of family planning strongly predicted women’s use of post-abortion contraception. Also, the findings revealed three main themes which characterised male partners’ involvement during abortions: knowledge of the abortion, roles during the abortion decision-making process, and provision of support for the abortion. Women's expectations of receiving financial support from their male partners was highly prioritised than the expectation of their partners’ involvement during the pregnancy decision-making process and expectation of emotional support. Others hoped to receive emotional and material support post-abortion whilst others had no expectations of receiving support from their partners. Barriers to male partners’ participation and inclusion in the abortion was a result of their lack of knowledge of and secrecy surrounding the pregnancy and abortion, partner abandonment, ambivalence about the pregnancy outcome, work-related demands, and parental responsibility for the pregnancy.

The findings from this study elucidate several theoretical and practical implications. Post-abortion services should aim at increasing women’s autonomy in contraceptive decision-making while encouraging inter-couple communication on family planning use. Availability of on-site family planning consumables, skilled abortion-care providers and comprehensive discussions on contraception should be integrated into the package of comprehensive abortion care delivery in health facilities in order to increase the prevalence and initiation of post-abortion contraception.