Safe Abortion

Development of a Conceptual Model and Survey Instrument to Measure Conscientious Objection to Abortion Provision

Laura Florence Harris
John Koku Awoonor-Williams
Caitlin Gerdts
Laura Gil Urbano
Ana Cristina González Vélez
Jodi Halpern
Ndola Prata
Peter Baffoe
2016

Background and objective: Conscientious objection to abortion, clinicians' refusal to perform legal abortions because of their religious or moral beliefs, has been the subject of increasing debate among bioethicists, policymakers, and public health advocates in recent years. Conscientious objection policies are intended to balance reproductive rights and clinicians' beliefs. However, in practice, clinician objection can act as a barrier to abortion access-impinging on reproductive rights, and increasing unsafe abortion and related morbidity and mortality. There is little...

Women’s Empowerment and Fertility: A Review of the Literature

Ndola Prata
Ushma D. Upadhyay
Jessica D. Gipson
Mellissa Withers
Shayna Lewis
Erica J. Ciaraldi
Ashley Fraser
Megan J. Huchko
2015

Women’s empowerment has become a focal point for development efforts worldwide and there is a need for an updated, critical assessment of the existing evidence on women’s empowerment and fertility. We conducted a literature review on studies examining the relationships between women’s empowerment and several fertility-related topics. Among the 60 studies identified for this review, the majority were conducted in South Asia (n = 35) and used household decision-making as a measure of empowerment (n = 37). Overall, the vast majority of studies found some positive associations between women’s...

Women’s Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015

Ndola Prata
Benjamin Nieto-Andrade
Eva Fidel
Rebecca Simmons
Dana Sievers
Anya Fedorova
Suzanne Bell
Karen Weidert
2017

In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between women’s choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15–49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for women’s contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and...

Making Abortion Safer in Rwanda: Operationalization of the Penal Code of 2012 to Expand Legal Exemptions and Challenges

Nuriye Nalan Sahin Hodoglugil
Fidele Ngabo
Joanna Ortega
Laetitia Nyirazinyoye
Eugene Ngoga
Evangeline Dushimeyezu
Eugene Kanyamanza
Ndola Prata
2017
Abstract

Penal code was revised in Rwanda in 2012 allowing legal termination of pregnancy resulting from rape, incest, forced marriage, or on medical grounds. An evaluation was conducted to assess women's access to abortion services as part of an ongoing program to operationalize the new exemptions for legal abortion. Data was collected from eight district hospitals; seven gender-based violence (GBV) centers and six intermediate courts. Three focus group discussions and 22 in-depth interviews were conducted with key informants. At hospitals, of the 2,644 uterine evacuation records (July...

Do perceived contraception attitudes influence abortion stigma? Evidence from Luanda, Angola

Ndola Prata
Madeline Blodgett
Karen Weidert
Benjamin Nieto-Andrade
2018

Abortion stigma is influenced by a variety of factors. Previous research has documented a range of contributors to stigma, but the influence of perceived social norms about contraception has not been significantly investigated. This study assesses the influence of perceived social norms about contraception on abortion stigma among women in Luanda, Angola. This analysis uses data from the 2012 Angolan Community Family Planning Survey. Researchers employed multi-stage random sampling to collect demographic, social, and reproductive information from a representative sample of...

Transportation cost as a barrier to contraceptive use among women initiating treatment for HIV in Tanzania

Lauren A Hunter
Ndola Prata
Brenda Eskenazi
Prosper F Njau
Sandra I McCoy
2022

Transportation cost is a barrier to HIV treatment, yet no studies have examined its association with contraceptive use among women living with HIV. We analyzed cross-sectional data from women attending three public healthcare facilities in Shinyanga, Tanzania where they initiated antiretroviral therapy for HIV infection in the previous 90 days; all facilities offered free contraception. Women self-reported current contraceptive use and the round-trip cost of transportation to the facility. Among 421 women aged 18–49, 86 (20.4%) were using any modern contraceptive method, of which...

Shining the light on abortion: Drivers of online abortion searches across the United States in 2018

Ndola Prata
Sylvia Guendelman
Elizabeth Pleasants
Elena Yon
Alan Hubbard
2020

Context

Legal abortion restrictions, stigma and fear can inhibit people’s voices in clinical and social

settings posing barriers to decision-making and abortion care. The internet allows individuals
to make informed decisions privately. We explored what state-level policy dimensions were
associated with volume of Google searches on abortion and on the abortion pill in 2018.

Methods

We used Google Trends to quantify the relative search volume (RSV) for “abortion” and
“abortion pill” (or “abortion pills” hereafter referred to as “abortion pill”) as a...

Quality of top webpages providing abortion pill information for Google searches in the USA: An evidence-based webpage quality assessment

Ndola Prata
Karen Weidert
Sylvia Guendelman
Elizabeth Pleasants
2021

Background

In the United States, the internet is widely used to seek health information. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood.

Methods
We used Google’s Custom Search Application Programming Interface (API) to identify the top 10 webpages presented for “abortion pill” searches on...

Abortion access barriers shared in “r/abortion” after Roe: a qualitative analysis of a Reddit community post-Dobbs decision leak in 2022

Elizabeth Pleasants
Karen Weidert
Lindsay Parham
Ndola Prata
Ushma Upadhyay
Eliza Dolgins
Emma Anderson
Coye Cheshire
Cassondra Marshall
2024

With drastic changes to abortion policy, the months following the Dobbs leak and subsequent decision in 2022 were a uniquely uncertain and difficult time for abortion access in the United States. To understand experiences of challenges to abortion access during that time, we used a hybrid inductive and
deductive thematic coding approach to analyse descriptions of barriers and their impacts shared in an abortion subreddit (r/abortion). A simple random sample of 10% of posts was obtained from those shared from 02 May 2022 through 23 December 2022; comments were purposively sampled during...

The association of experiences of medical mistrust and mistreatment and ever considering self-managing an abortion.

Aliza Adler
M Antonia Biggs
Shelly Kaller
Rosalyn Schroeder
Ndola Prata
Karen Scott
Lauren Ralph
2025

Objective: To assess the prevalence of ever considering self-managing an abortion (SMA) and its associations with experiences of medical mistrust and mistreatment in a nationally representative sample.

Study design: In 2021-22, we conducted a national, cross-sectional, online probability-based survey of US people assigned female at birth ages 15-49. Among those who had ever been pregnant, we ran weighted multivariable logistic regressions to examine whether having had difficulty trusting medical providers and/or experiencing medical mistreatment was...