Phenomenology of Induced Abortion in Northern Uganda Among HIV-Positive Women Following an Unintended Pregnancy

Amir Kabunga; Alfred Acanga; Judith Akello Abal; Caroline Kambugu Nabasirye; Halimah Namata; David Mwesigwa; Anna Grace Auma; Eustes Kigongo; Samson Udho

doi:10.2147/OAJC.S407547

Phenomenology of Induced Abortion in Northern Uganda Among HIV-Positive Women Following an Unintended Pregnancy

Open Access J Contracept. 2023 Apr 20:14:73-82. doi: 10.2147/OAJC.S407547. eCollection 2023.

Authors

Amir Kabunga¹, Alfred Acanga², Judith Akello Abal³, Caroline Kambugu Nabasirye⁴, Halimah Namata⁵, David Mwesigwa², Anna Grace Auma⁴, Eustes Kigongo⁶, Samson Udho⁴

Affiliations

¹ Department of Psychiatry, Lira University, Lira, Uganda.
² Department of Public Administration and Management, Lira University, Lira, Uganda.
³ Department of Commerce and Business Management, Lira University, Lira, Uganda.
⁴ Department of Midwifery, Lira University, Lira, Uganda.
⁵ Department of Mental Health, Makerere University, Lira, Uganda.
⁶ Department of Infectious Diseases, Lira University, Lira, Uganda.

Abstract

Background: More than half of pregnancies in Uganda are unintended, and nearly a third of these end in abortion. However, little research has focused on women living with HIV's subjective experiences following induced abortion. We explored how women living with HIV subjectively experience induced abortions in health facilities in Lira District, Uganda.

Materials and methods: This was a descriptive-phenomenological study between October and November 2022. The study was conducted among women of reproductive age (15-49 years) who were HIV positive and had undergone induced abortion following an unintended pregnancy. Purposive sampling was used to sample 30 participants who could speak to the research aims and have experience with the phenomenon under scrutiny. The principle of information power was used to estimate the sample size. We conducted face-to-face, in-depth interviews to collect data. Data were presented as direct quotes while providing a contextual understanding of the lived experiences of the study participants.

Results: The results showed that the major causes of induced abortion were financial constraints, concern for the unborn babies, unplanned pregnancy, and complex relationships. Regarding induced abortion-related experiences, three themes emerged: loss of family support, internalized and perceived stigma, and feelings of guilt and regret.

Conclusion: This study highlights the lived experiences of women living with HIV following an induced abortion. The study shows that women living with HIV had induced abortions due to numerous reasons, including financial concerns, complicated relationships, and a fear of infecting their unborn babies. However, after induced abortion, the women living with HIV faced several challenges like loss of family support, stigma, and feelings of guilt and regret. Based on HIV-infected women who underwent induced abortion and an unexpected pregnancy, they may need mental health services to reduce the stigma associated with induced abortion.

Keywords: abortion; lived experiences; unintended pregnancy.

Grants and funding

This research work was supported by a seed grant from the Center for International Reproductive Health Training at the University of Michigan (CIRHT-UM). The content is solely the responsibility of the authors and does not necessarily represent the official views of CIRHT-UM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.