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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries
(52 percent) sought abortion in the first 10 weeks, 37 percent sought it between 10 and 16 weeks of pregnancy and 11 percent sought it between 16 and 20 weeks (Mpangile, Leshabari, and Kihwele, 1999).
Unmarried young women, are, moreover, considerably more likely to resort to clandestine abortions and unskilled providers (Ehrenfeld, 1999; FOCUS on Young Adults, 2001; Ganatra and Hirve, 2002; Mpangile, Leshabari, and Kihwele, 1999; The Alan Guttmacher Institute, 1998; Varga, 1997). The need for confidentiality is a leading reason underlying this preference. For example, studies in India report that confidentiality was the leading criterion in the selection of a provider—outranking safety and convenience criteria. One such study observed that young women, whether married or not, were more likely to seek abortion from untrained providers, traditional birth attendants, paramedical workers, as well as medical practitioners unlicensed in providing abortion: while 22 percent of older women underwent abortion from an untrained provider, this proportion reaches almost one-third among young women who were married, and almost one-half among young women who were unmarried (Ganatra, forthcoming; Ganatra and Hirve, 2002). A study in Dar es Salaam, Tanzania, reports similarly that, of the abortion providers reported by young women who had undergone abortion, only 22 percent were identified as doctors; 65 percent were described as “other health workers” and 13 percent as “quacks” (Mpangile, Leshabari, and Kihwele, 1999). In urban Cameroon, abortions obtained before age 20 were more likely to be reported as self-induced or performed by an untrained person than were abortions performed after age 20 (Calvès, 2002).
In the study in India, while cost was cited as the leading motive for this choice among young married women, confidentiality was the leading reason reported by the unmarried; in general, young women were more likely to report, moreover, that the provider had not explained the abortion procedure (Ganatra and Hirve, 2002). The case study in Dar es Salaam also reports that cost considerations prompted provider selection, and that providers neither counseled nor gave them information or contraceptive supplies (Mpangile, Leshabari, and Kihwele, 1999).
An ethnographic study in Lombok, Indonesia, reported similarly that even though providers were willing to provide abortions to unmarried women, they remained highly critical of unmarried pregnant women and as a result the quality of services provided to them was compromised: no attempt was made to explain the abortion procedure or postabortion contraception, provider attitudes were judgmental, and no counseling was provided. Doctors themselves corroborated these attitudes, labeling unmarried young abortion seekers as immoral and bad (Bennett, 2001).
And in China, where abortion is legally available in the first trimester, a large number of migrant young women in urban areas sought abortion