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Medication abortion has been established globally as safe and effective. This modality has increased accessibility and the opportunity to centre individual autonomy at the heart of abortion care, by facilitating self-managed abortion. Previous research has shown how self-managed abortion is beneficial in myriad settings ranging from problematic to (relatively) unproblematic contexts of access. In this paper we explore the relationship between self-management and sources of support (including health professionals, family, and friends); as well as considering issues of reproductive control and autonomy. Drawing on qualitative, experience-centred interviews, we utilise the concept of social connectedness to examine how supported self-managed abortion was experienced in the United Kingdom during the COVID-19 pandemic. Overall, self-management was welcomed, with participants speaking positively about managing their own abortion at home. However, a sense of connectedness was crucial in helping participants deal with difficult experiences; and functioned to support individual autonomy in self-care. This paper is the first to examine factors of connection, support, and isolation, as experienced by those undergoing self-managed abortion in the UK in detail. Our research suggests a continued need to advocate for high quality support for self-managed abortion, as well as for choice of abortion method, to support patient-centered care. [ABSTRACT FROM AUTHOR]

Young mothers often encounter stigma and discrimination, affecting their lives and that of their children. This paper explores stigma management strategies and their effectiveness for young mothers in rural Nigeria. Ten key informants and 24 young mothers were recruited from Ife-East in South-Western Nigeria. Data from semi-structured interviews showed that societal disapproval of pregnant teenagers and young mothers were common experiences. Women used a range of strategies to actively cope with stigma including: belief in predestination, avoidance, concealment, and cohabitation. These strategies could be seen as tools to mitigate negative stereotypes and discrimination. However, they also had the unintended consequences of compounding many young women’s difficult circumstances and exposing them to adverse outcomes, including gender-based violence, repeat pregnancies, poor mental health, and low uptake of services. The results show the need for policy frameworks to actively combat stigma by addressing the negative framing of early pregnancy and motherhood and promoting supportive environments for young mothers. Health professionals need to be trained to offer de-stigmatising services to encourage young mothers to seek help and reduce pre-existing inequities in access to services, and policies need to include measures that address the rights of young mothers and protect them from violence and abuse. [ABSTRACT FROM AUTHOR]

Continued pregnancy after an abortion attempt is a likely outcome in countries where unsafe abortions prevail. Yet there is a paucity of literature on the consequences and implications of failed abortions. This study explored young women's abortion decision-making, their experiences of failed abortion and its consequences in South-Western Nigeria. It presents findings from semi-structured interviews conducted with 14 women who had become unintentionally pregnant as unmarried teenagers, desired abortions, yet became mothers. Whilst the fear of the stigma associated with young unmarried motherhood gave rise to participants' desire for abortion, restrictive abortion laws influenced their experiences and abortion decision-making. Participants who attempted an abortion failed and were forced to carry their unwanted pregnancies to term. They then experienced continued discrimination, forced motherhood, and a rejection of maternalism. Their experiences are analysed as responses to the complex interplay between social norms, abortion restrictions, stigma and forced motherhood. The paper makes a case for improving women's reproductive autonomy in decision-making, – highlighting the social and mental health consequences of restricted access to abortion, and reinforce the importance of taking a holistic approach to addressing the sexual health of young women, by focusing not only on physical health but also on ensuring wellbeing. [ABSTRACT FROM AUTHOR]

Much care has been paid to reflexivity, including considering emotional sensitivities in relation to face-to-face interviews. However, less attention has been paid to the impact of sensitivities on the process of data analysis and the presentation of research findings. This paper focuses on what constitutes 'the data' to be analysed, who analyses and interprets the data, what is silenced and what is made public, and what this might mean for feminist research practice in areas considered to be 'sensitive'. It examines these issues by focusing on research on abortion decision-making in which the views and emotions of the researcher were profoundly challenged by women's constructions of narratives containing a theme of abortion regret. The paper demonstrates how theoretical perspectives – in this case, feminist standpoint theory – can be used in sensitive research, to allow the researcher to resolve such tensions by providing a means through which greater attention can be paid to the context of participants' narratives. [ABSTRACT FROM AUTHOR]

In most settings worldwide, abortion continues to be highly stigmatised. Whilst a considerable body of literature has addressed abortion stigma, what is less commonly examined are the ways in which those with experience of abortion describe it in non-negative terms which may resist or reject stigma. Drawing on qualitative secondary analysis of five UK datasets using a narrative inquiry approach, we explore: the use of non-negative language around abortion, potential components of a normalising narrative, and constraints on non-negativity. As such, we present the first empirical UK study to critically examine how a dominant negative abortion narrative might be disrupted. [ABSTRACT FROM AUTHOR]

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women’s pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism. [ABSTRACT FROM AUTHOR]

In the UK, long-acting reversible contraceptives have been welcomed by sexual health policy-makers and many practitioners as a particularly effective way of preventing unintended pregnancy, especially teenage conception. However, little is known about women's individual experiences of these forms of contraception beyond limited data on retention rates and reasons for discontinuation. The main aims of this research were to gain a fuller understanding of why some young women have their implants removed, and what may help them maintain this method of contraception if they wish to do so. The contraceptive choices of 20 young women (aged 16–22) who had chosen the implant, and later discontinued it, were examined. They had experienced unacceptable side effects that they attributed to the implant, and interpreted as a threat to their bodily control, which they were not prepared to tolerate. These feelings were exacerbated if they then encountered delays after requesting removal. Although they remained concerned to avoid unintended pregnancy, they generally moved to a less reliable form of contraception following implant removal and felt discouraged from trying other long-acting contraception. We suggest that principles of contraceptive choice should include facilitating the discontinuation of unsatisfactory methods; implant removal should therefore be readily available when requested, regardless of the length of time the implant has been in place. Long-acting forms of contraception do not suit all women, and will not obviate the need for other forms of reproductive control, including legal abortion. Au Royaume-Uni, les contraceptifs réversibles à longue durée d'action ont été accueillis favorablement par les décideurs en santé sexuelle et beaucoup de praticiens comme moyen particulièrement efficace de prévenir les grossesses non désirées, spécialement chez les adolescentes. Néanmoins, on connaît mal l'expérience individuelle des femmes, à part les données sur les taux de rétention et les raisons de l'interruption de ces formes de contraception. Les objectifs principaux de cette recherche étaient de mieux comprendre pourquoi certaines jeunes femmes se font enlever leur implant et qu'est-ce qui peut les aider à conserver cette méthode de contraception si elles le souhaitent. Les choix contraceptifs de 20 femmes (âgées de 16 à 22 ans) qui avaient sélectionné l'implant, puis l'avaient abandonné, ont été examinés. Ces femmes avaient enregistré des effets secondaires inacceptables qu'elles avaient attribués à l'implant. Elles les avaient interprétés comme une menace pour leur maîtrise corporelle qu'elles n'étaient pas disposées à tolérer. Le fait de devoir attendre après avoir demandé le retrait de l'implant avait exacerbé ces sentiments. Même si elles souhaitaient encore éviter les grossesses non désirées, elles étaient généralement passées à une contraception moins fiable après le retrait de l'implant et n'avaient plus envie d'essayer d'autres contraceptifs de longue durée. Les principes du choix contraceptif devraient inclure des mesures pour faciliter l'abandon de méthodes non satisfaisantes ; l'implant devrait donc être retiré dès que demandé, quelle que soit la durée de sa mise en place. Les formes de contraception de longue durée ne conviennent pas à toutes les femmes et n'élimineront pas la nécessité d'autres méthodes de maîtrise de la fécondité, notamment l'avortement légal. En el Reino Unido, los anticonceptivos reversibles de acción prolongada son bienvenidos por formuladores de políticas de salud sexual y muchos profesionales de la salud como una manera especialmente eficaz de evitar embarazos no deseados, en particular la concepción en la adolescencia. Sin embargo, no se sabe mucho acerca de las experiencias personales de las mujeres con estos anticonceptivos aparte de los datos limitados sobre las tasas de retención y las razones para abandonar el método. Los objetivos principales de esta investigación eran entender mejor por qué algunas jóvenes solicitan que se les extraigan los implantes y qué podría ayudarlas a mantener este método anticonceptivo si así lo desean. Se examinaron las opciones anticonceptivas de 20 jóvenes (de 16 a 22 años de edad), quienes habían elegido el implante y después lo abandonaron. Presentaron efectos secundarios inaceptables, que atribuyeron al implante e interpretaron como un peligro para el control de su cuerpo, lo cual no estaban preparadas para tolerar. Estos sentimientos fueron exacerbados si luego encontraron demoras tras solicitar la extracción. Aunque continuaron preocupadas por evitar embarazos no intencionales, generalmente pasaron a usar un anticonceptivo menos confiable después de la extraccción del implante y se sintieron disuadidas de probar otros anticonceptivos de acción prolongada. Sugerimos que los principios de elección de anticonceptivos incluyan facilitar el abandono de métodos poco satisfactorios. Por lo tanto, cuando se solicite la extracción del implante, ésta debe efectuarse con prontitud, independientemente del tiempo que lleva colocado el implante. Los anticonceptivos de acción prolongada no son adecuados para todas las mujeres y no harán innecesaria otras formas de control reproductivo, como la interrupción legal del embarazo. [ABSTRACT FROM AUTHOR]

Policy discussion of teenage sexual behaviour has been strongly influenced by a political agenda that characterises teenage pregnancy as a potential ‘risk’ of sexual activity. This presumed risk framework, however, depends upon an assumption of shared value judgements about the social undesirability of teenage parenthood, and the moral undesirability of teenage abortion. Drawing on three qualitative research projects undertaken in England between 2003 and 2009, this article looks at the complex processes of individual pregnancy decision making, in a context of competing values and moralities. It provides insights into, and understandings of, underlying tensions in the processes through which different degrees of personal autonomy may be experienced, and suggests that when autonomous decision making is compromised, often due to tensions in competing value systems, young women may experience ambivalence or regret about the decision they have made. [ABSTRACT FROM AUTHOR]