Abortion decision making among young adults in a metropolitan region of the Philippines

Background: Despite the illegality of abortion in the Philippines, roughly 13% of pregnancies end in induced abortion each year. Little attention has been paid to abortion decision-making in this setting and prior research on abortion has focused solely on women and often only in clinical settings. The current study integrates a socio-ecological perspective to understand abortion decision-making among a community-based sample of young adults. Methods: In-depth qualitative interviews (n=52) were conducted in 2007-08 with 13 young adult couples living in a metro area of the Philippines who reported a negative reaction to a previous pregnancy. Focus group discussions (n=9) were also conducted. Results: Abortion discussions were common in our sample with many respondents reporting to have either considered or attempted abortion. Fears of bringing shame to one's family or oneself if an unintended pregnancy was disclosed were widespread and significantly contributed to the desire to terminate. Males often took “responsibility” for a pregnancy and supported disclosure to their partners' families. Many respondents reported feeling conflicted between wanting to establish a household independent from their parents and feeling financially dependent on extended family members. Perhaps reflecting shifting norms supporting greater independence, females were more likely to discuss employment or education as impacting their continuation of a pregnancy. Conclusion: Results show that abortion is being discussed and that abortion decision-making is not localized to the couple, but rather includes the simultaneous influence of family support and broader cultural environment.