Male Partners’ Involvement in Abortion and Uptake of Post-Abortion Family Planning Services.

Abstract

Male involvement in abortion and post-abortion family planning use is pivotal in reducing unintended pregnancies while optimising contraceptive use. While literature is extant with the positive outcomes of men’s role in abortion and contraceptive use, there is insufficient interrogation of the relationship between male partners’ involvement in abortion and post-abortion family planning uptake. This study sought to examine the relationship between male partners’ involvement in abortion and immediate use of post-abortion contraception in the Greater Accra Region. The specific objectives were to: explore the extent of male partners’ participation in abortion; women's expectations of their partners’ roles in the abortion and barriers to partners’ inclusion and participation in abortion. Using a sequential mixed method approach, data were obtained first through in-depth interviews and participant observations from women and their male partners, followed by a survey of only women. The data collection was conducted in four purposively selected health facilities in the Greater Accra Region. At the end of the study, 41 interviews were conducted and 356 respondents participated in the survey. Thematic analysis of the qualitative data was done using the Nvivo software. Multiple logistic regression analysis was performed with SPSS to determine the relationship between male partners’ involvement in abortion and uptake of post-abortion family planning. The results of the study showed three main themes which characterised male partners’ involvement during abortion: knowledge of the abortion, the role of male partners during the abortion decision-making process, and provision of support for the abortion. Women's expectations of receiving financial support from their male partners was highly prioritised over the expectation of their partners’ involvement during the abortion decision-making process and expectation of emotional support. Some women hoped to receive emotional and material support after the abortion whilst others had no expectations of receiving support from their partners. Barriers to male partners’ participation and inclusion in the abortion was a result of their lack of knowledge of and secrecy surrounding the pregnancy and abortion, partner abandonment, ambivalence about the pregnancy outcome, work-related demands, and parental responsibility for the pregnancy. Furthermore, communicative support provided by the male partners during the abortion process strongly predicted women’s use of post-abortion contraception. Women were less likely to adopt a contraceptive method after the abortion if they received emotional support from their male partners at the time of the abortion. The woman’s employment, self-efficacy and level of family planning knowledge were significantly associated with post-abortion family planning uptake whilst male partners’ educational level, ethnicity and knowledge of family planning strongly predicted women’s use of post-abortion contraception. The findings from this study elucidate several theoretical and practical implications. Post-abortion services should aim at increasing women’s autonomy in contraceptive decision-making while encouraging inter-couple communication on contraceptive use. Availability of on-site family planning consumables, skilled abortion-care providers and comprehensive discussions on contraception should be integrated into the package of comprehensive abortion care delivery at health facilities in order to increase the prevalence and initiation of post-abortion contraception.