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The USA, a country with widespread access to the full range of modern methods of contraception, continues to have one of the highest abortion rates among developed countries. Forty-nine per cent of women reported ever experiencing an unintended pregnancy in 2001; 48% of these conceptions occurred during a month that contraception was used. We explored the extent to which people use contraception and abortion interchangeably to achieve their fertility goals via focus groups (n=4) and semi-structured in-depth interviews (IDIs) (n=18) with men and women between the ages of 18 and 35 in New York City in 2006. While there was a consensus that abortion cannot replace contraceptive use, poor couple communication, lack of planning, lack of acceptable contraceptive methods and the pleasures that people associate with having unprotected sex result in the perception that some individuals rely on abortion over contraception to prevent unintended births. Men and women both identified women as solely in charge of avoiding an unwanted pregnancy and resolving it should one occur. No one supported repeat abortions for themselves or others, and many respondents perceived multiple abortions to lead to infertility, which strengthens their position that substituting abortion for contraception is unacceptable. [ABSTRACT FROM AUTHOR]

It is well recognised that unsafe abortions have significant implications for women's physical health; however, women's perceptions and experiences with abortion-related stigma and disclosure about abortion are not well understood. This paper examines the presence and intensity of abortion stigma in five countries, and seeks to understand how stigma is perceived and experienced by women who terminate an unintended pregnancy and influences her subsequent disclosure behaviours. The paper is based upon focus groups and semi-structured in-depth interviews conducted with women and men in Mexico, Nigeria, Pakistan, Peru and the United States (USA) in 2006. The stigma of abortion was perceived similarly in both legally liberal and restrictive settings although it was more evident in countries where abortion is highly restricted. Personal accounts of experienced stigma were limited, although participants cited numerous social consequences of having an abortion. Abortion-related stigma played an important role in disclosure of individual abortion behaviour. [ABSTRACT FROM AUTHOR]

Why is induced abortion common in environments in which modern contraception is readily available? This study analyses qualitative data collected from focus group discussions and in-depth interviews with women and men from low-income areas in five countries - the United States, Nigeria, Pakistan, Peru and Mexico - to better understand how couples manage their pregnancy risk. Across all settings, women and men rarely weigh the advantages and disadvantages of contraception and abortion before beginning a sexual relationship or engaging in sexual intercourse. Contraception is viewed independently of abortion, and the two are linked only when the former is invoked as a preferred means to avoiding repeat abortion. For women, contraceptive methods are viewed as suspect because of perceived side effects, while abortion experience, often at significant personal risk to them, raises the spectre of social stigma and motivates better practice of contraception. In all settings, male partners figure importantly in pregnancy decisions and management. Although there are inherent study limitations of small sample sizes, the narratives reveal psychosocial barriers to effective contraceptive use and identify nodal points in pregnancy decision-making that can structure future investigations. [ABSTRACT FROM AUTHOR]