Abstract
Objectives
For a person seeking an abortion, the ability to recognise a pregnancy is a critical
first step. Pregnancy recognition is complex and shaped by numerous factors. This
paper explores the experiences of pregnancy recognition among adolescents in Ethiopia,
Malawi, and Zambia.
Study Design
The final sample included three hundred and thirteen adolescents aged 10-19 who had
sought abortion-related care at urban public facilities in Ethiopia (N=99), Malawi
(N=104), and Zambia (N=110). Researchers collected mixed-method data on how adolescents
came to recognise that they were pregnant and thematically analysed qualitative data
alongside descriptive statistics from quantitative data.
Results
Most adolescents reported that their main mode of recognising a pregnancy was medical
pregnancy tests or late menstruation. Reasons for not recognising a pregnancy included
irregular menses or recent menarche and attribution of signs and symptoms to other
medical conditions. Psychological barriers to pregnancy recognition were important,
including the refusal to accept a pregnancy and denial of a pregnancy. Timing of recognition
shaped the abortion care available for adolescents and the affordability of care.
For some adolescents, their capacity to recognise their pregnancy led to involuntary
or voluntary disclosure, which decreased their reproductive autonomy.
Conclusion
Adolescent experiences of pregnancy recognition complement existing evidence, illustrating
critical barriers across age and context. Interrogating pregnancy recognition among
adolescents exposed the critical implications for the availability, accessibility,
affordability, and autonomy of their abortion trajectory.
Keywords
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Article info
Publication history
Accepted:
March 10,
2023
Received in revised form:
March 2,
2023
Received:
August 23,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Published by Elsevier Inc.
