Barriers to utilisation of contraceptives and available support systems during and after induced abortion among adolescents in East London, South Africa: A qualitative study

Abstract

Adolescent pregnancy is a concern worldwide and has risen at an alarming rate in South Africa. Many teenage pregnancies end up being aborted. Despite the availability of contraceptives free of charge in public health institutions, unintended pregnancies among adolescents still persist. These unintended pregnancies result in a high rate of induced abortion, both safe and unsafe. The study was conducted to explore and describe the perceptions of adolescents regarding induced abortion in two public hospitals in East London, South Africa. This qualitative study involved 24 purposively sampled participants. Data were collected by means of individual interviews and analyzed using Tech’s steps. Themes, categories, and subcategories were identified following data analysis. All adolescents admitted having consensual unprotected sex. Adolescents emphasised that they had abortions because they had no choice and in view of their poor-socio economic status. Some findings were that adolescent men were against abortion and they had to be persuaded by their female counter parts. The results also indicated poor treatment by the nursing staff at the family planning clinics resulting in defaulting on scheduled famility planning visits. Shortage of staff was a contributing factor to the poor treatment of adolescents in the family planning clinics. Adolescents confirmed that contraception at the clinics was not prioritised. Perceptions of reasons for adolescents choosing induced abortion ranges from psychosocial to socio-economic reasons. The main barriers to utilization of contraceptive among adolescents are myths and misconceptions as well as nurses’ negative attitude. Suggested intervention strategies included proper use of contraceptives, improved service delivery by competent nursing staff and supervision as well as tracing of family planning defaulters.

Key words: Adolescent, contraceptive, induced abortion, teenage pregnancy.