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An illusion of power: Qualitative Perspectives On Abortion Decision-Making Among Teenage Women In Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
2009 (English)In: Perspectives on sexual and reproductive health, ISSN 1538-6341, E-ISSN 1931-2393, Vol. 41, no 3, 173-180 p.Article in journal (Refereed) Published
Abstract [en]

CONTEXT:Swedish law permits abortion at the request of a pregnant woman untilthe 18th week of gestation. However, the extent to which the decision istruly the woman's own is subject to debate; women are often influenced,directly or indirectly, by the attitudes of their partners, family andfriends or by social norms. METHODS: Individual in-depth interviewsabout the pregnancy and the abortion decision were conducted 3-4 weekspostabortion with 25 women aged 16-20 at different periods in 2003, 2005and 2007. Interviews were audio-taped, transcribed verbatim andanalyzed using latent content analysis. RESULTS: The main reasons forunplanned pregnancy were underestimation of pregnancy risk andinconsistent contraceptive use. Pregnancy prevention was perceived asthe woman's responsibility. The abortion decision was accompanied bymixed emotions, and was seen as a natural yet difficult choice. Socialnorms and the negative attitudes of family and friends stronglyinfluenced the decision. Partners and parents were regarded as the mostimportant sources of support. After the abortion, the women feltpressured by contraceptive counselors to use highly effectivecontraceptives despite their previous negative experiences or worriesabout side effects. CONCLUSIONS: Swedish teenagers' basic right todecide whether to have an abortion may be limited by societal norms anddisapproval of teenage childbearing. Given the perception that women areresponsible for contraception, programs need to emphasize thatpregnancy prevention is a shared responsibility; greater efforts toinclude males in prevention practices are needed.

Place, publisher, year, edition, pages
2009. Vol. 41, no 3, 173-180 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96961DOI: 10.1363/4117309ISI: 000269543000005PubMedID: 19740236OAI: oai:DiVA.org:uu-96961DiVA: diva2:171710
Available from: 2008-04-03 Created: 2008-04-03 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Sexual Risk Taking: – Perceptions of Contraceptive Use, Abortion, and Sexually Transmitted Infections Among Adolescents in Sweden
Open this publication in new window or tab >>Sexual Risk Taking: – Perceptions of Contraceptive Use, Abortion, and Sexually Transmitted Infections Among Adolescents in Sweden
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Sexuellt risktagande : – svenska ungdomars inställning till, och erfarenhet av preventivmedel, abort och sexuellt överförbara infektioner
Abstract [en]

The overall aim of this thesis was to inestigate Swedish adolescents' perceptions and behaviours regarding sexual risk taking. Specific objectives were to explore teenagers' perceptions of contraceptive use, unintended pregnancy, and abortion; teenage girls' experiences of decision making process and support connected to abortion; and male adolescents' perceptions of sexual risk taking and barriers to practicing safe sex. Another objective was to evaluate the effect of advance provision of emergency contraceptive pills to teenage girls. The methodologies included focus group discussions, in-depth interviews, and a randomized controlled trial.

Among the adolescents in our studies, teenage parenthood was generally viewed as a "catastrophe", and the majority expressed supportive attitudes towards abortion (studies I-IV). Occasions of failure to use contraceptives were common, especially when sex was unplanned (studies I-V). Pregnancy prevention was perceived as the woman's responsibility. However, many girls were reluctant about using homonal contraceptives due to worries about negative side effects (I, III). Initiating condom use was difficult for girls, as well as for boys, for a number of reasons (I-IV): fear of ruining an intimate situation, associations with disease, distrust, pleasure reduction, and (for the boys) the fear of loosing one's erection. Males generally perceived personal and partner-related risks connected to unprotected intercourse as low. Few males were worried that an unintended pregnancy would be carried to term, and the majority would urge the girl towards abortion if she seemed ambivalent (II, IV). Girls viewed the abortion decision as a natural, yet difficult choice, strongly influenced by attitudes of partners, parents, peers and societal norms (III). Teenage girls provided with emergency contraceptive pills in advance used it more frequently and sooner after unprotected intercourse compared with controls, without jeopardising regular contraceptive use (V).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 81 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 325
Keyword
Obstetrics and gynaecology, Adolescents, attitudes, sexual risk taking, contraceptive use, unintended pregnancy, teenage abortion, communication, gender, decision making, STI, Chlamydia, condom use, Health Belief Model, emergency contraception, RCT, Obstetrik och kvinnosjukdomar
Identifiers
urn:nbn:se:uu:diva-8598 (URN)978-91-554-7144-6 (ISBN)
Public defence
2008-04-25, X, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2008-04-03 Created: 2008-04-03Bibliographically approved

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Ekstrand, MariaTydén, TanjaDarj, ElisabethLarsson, Margareta

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