A new approach to eliciting information about induced abortion
Huntington, D.; Mensch, B.; Toubia, N.
Studies in Family Planning 24(2): 120-124
1993
ISSN/ISBN: 0039-3665 PMID: 8390117 DOI: 10.2307/2939205Document Number: 327389
Considerable underreporting occurs in survey data based on the respondent's declaration about an induced abortion. The World Fertility Surveys were the main instrument for assessing the incidence of induced abortion. Revised Demographic and Health Surveys asked about "induced abortions, miscarriages, and stillbirth," but did not separate out abortion. In the Ivory Coast, experimental data were collected on induced abortion as part of an operations research study of quality of care in family planning (FP) clinics. The questions asked are considered applicable to any population-based or facility-based survey. A brief summary of FP in the Ivory Coast is provided. Situation analysis methodology was used in the 9-month study which took place between February, 1992 and April, 1993. Interviews were conducted with service delivery point staff and new acceptors before and after their FP consultations. The approach used for the abortion questions was to emphasize unwantedness and to ask what community women might think about abortion. Pretesting confirmed that interviews would elicit frank responses when conducted in a confidential and value-free manner. 44% (152 women) reported a history of unwanted pregnancy, of which 59% stated that the pregnancy was terminated. Another 6% indicated having attempted an abortion. Failure to responses was 1%. In the exit interviews, 25% of FP clients reported a history of abortion (90 out of 347 women). 3% reported unsuccessful attempts to self-abort. A significant number of younger women had a successful abortion as compared to women who took other actions. 2% became pregnant while using a FP method. The reasons reported for not wanting a pregnancy were husband's or partner's objection (35%), economic constraints (16%), and social unacceptability as in the case of a single or young woman (16%). 75% of the clinic staff reported that there were client requests for advice on abortion. Clinic staff (46 persons) provided 106 different responses to the question about acceptable reasons for abortion. The most common responses were maternal health reasons (31%), saving a woman's life (27%), and risk to fetal health or fetal handicap (22%).