Hesperian Health Guides

Guide community discussions on abortion

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HealthWiki > Health Actions for Women > Chapter 9: Preventing Deaths from Unsafe Abortion > Guide community discussions on abortion

2 women having a conversation.
My talk about abortion was a disaster! I asked for their thoughts and people ended up yelling at each other. And last week in the clinic another girl almost died from an abortion someone did using a stick. We saved her life, but she will never be able to get pregnant.
People have strong feelings and opinions about abortion but no practice talking about it. What about using a more guided activity with a story everyone can relate to?

There are many reasons it can be challenging to talk about abortion. Some cultures and religions believe that a fetus is a human being, so for them abortion is simply murder. Even if the woman’s life is at risk, or her pregnancy is a result of rape or incest, they still believe the fetus should be protected. Others believe that it should be the woman’s right to choose whether she delivers a baby or not, and that all women should always have access to safe and affordable abortions.

Also, talking about unintended pregnancy means talking about people having sex, which is uncomfortable for many people, and even more so if discussing young or unmarried women being sexually active.

It is easy to see why it can be difficult to have a community discussion about abortion! But as long as women are dying from unsafe abortions, we need to find ways to talk about this problem.

Before leading a discussion about abortion, it is important to reflect on your own attitudes and get support if you are uncomfortable with this issue. See Preparing to lead discussions about sex and sexuality and the activities in Appendix B for some ideas about how to help yourself prepare to talk about a topic you are not comfortable with.

Use stories like the ones in "Guide community discussions on abortion" to help people discuss why abortion is not a simple question of right or wrong.

Involve men in discussing abortion

While it is important for women of all ages to talk about abortion with each other, it is also important to reach out to men, either in community meetings or with activities just for them. Men are affected by unintended pregnancies too!

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You can do most of the activities in this chapter with groups of men to help make them more comfortable talking about abortion and women’s health.

Any conversation about abortion will raise questions about gender roles. Encourage men to listen to women’s stories to understand how women feel. They can also learn by sharing stories with each other about what has happened, or might happen, to their wives, mothers, and daughters. Many men support women’s access to safe abortion services, and they can be important allies in participating in community dialogues, as well as providing practical help, such as transportation for women who must travel to get a safe abortion.

a man speaking in a group; another man responds.
I was angry with my daughter. I never expected her to do such a thing. But now I regret that. She needed my support, and I should have been most concerned about her health.
Would you be willing to share your story at the community meeting next week? It might help other fathers think better about their daughters.

Stories can help start discussion

Stories can be good ways to start a discussion about unintended pregnancies, the reasons why some women choose to end a pregnancy, and the risks they face when unsafe abortions are the only means available. Telling a story can help people to imagine a woman they know — a sister, friend, or daughter — facing the same situation. And stories can also help people see more clearly how abortion is a women’s health issue.

ActivityA walk in her shoes

  1. Tell a story about a woman who is pregnant and does not want to be. You can use one of the sample stories below or prepare a story that could happen to a woman in your community.
  2. Ask everyone to close their eyes and imagine themselves as the woman in the story. To help people "walk in the woman’s shoes," ask questions such as these: If you were the woman in the story:
    • How would you feel if you found out you were pregnant?
    • Would you tell anyone? Who? Who would you definitely not tell? Why would you tell someone or why not?
    • What would you be afraid of or worried about?
    • What might you do about the pregnancy?
  3. Take a few minutes for people to share with the whole group what they thought or felt during this exercise. Remind the group about sharing ideas respectfully by taking turns. Everyone should listen more than they talk.

Tips for creating discussion stories about unintended pregnancies:

  • Try to create stories that do not have simple solutions. Show the real difficulties of an unintended pregnancy. Include the hopes and future plans of the woman, people who support the woman, and people who pressure her to make a certain decision.
  • Do not use names of real people or examples that seem to be about a real person in the community. This could cause painful gossip and misunderstandings.
  • It is very common for people to think only certain types of women have abortions or become pregnant without wanting to. So make sure to tell stories about women of different ages, from different backgrounds, and from different social classes.

Four sample stories about unintended pregnancy

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Dorica has 4 children. Just after her husband left to work in another country, Dorica discovered she was pregnant. Because her husband could not find work in their country, she is not sure he will ever return, and she feels she cannot care for another child. She knows a woman who does abortions with herbs, but she is afraid people will find out. A few years ago, a friend of Dorica’s almost bled to death after an unsafe abortion. When her friend went to the hospital, the police questioned her and now everyone in the community talks about her.
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Amina’s mother died when she was 8 years old. Her father sent her to live in a rural village with his older sister and her husband. For 5 years, her uncle has sexually abused her and threatened her so she would not tell anyone. Amina never went to school. She sells flowers at the market and has to give all of her money to her uncle. At 13, Amina has just learned she is pregnant. She cannot endure carrying her uncle’s child, but she fears telling anyone about the abuse or pregnancy because she thinks she will be thrown out of the house.
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Zanzele is a mother of 2 young children. Her husband left her 2 months ago when she tested HIV positive. He accused her of being with someone else and refused to be tested himself. Zanzele has not told anyone else she has HIV because she is afraid of the way people treat those with HIV. Zanzele just found out she is 10 weeks pregnant. She knows she cannot support another child and she feels alone and scared.
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Ranya was 16 when she got pregnant. The condom that her boyfriend was using broke. They love each other and are planning to get married, but they both had hoped to finish school first. They do not feel ready to have a baby. Ranya’s parents were angry at first, but they have now forgiven her and have offered to support her during the pregnancy. They both work, however, and will not be able to help with childcare after the baby is born.

Causes and consequences of unintended pregnancy

Before a group is ready to discuss actions to prevent unsafe abortion, it helps to explore more deeply the causes of unintended pregnancy, the options a woman who is pregnant may have, and what each option might mean for her. Many activities in this book can be useful for doing this. Here is an example of how to adapt the Problem Tree to guide a discussion on these issues.

ActivityA Problem Tree to discuss unintended pregnancy

Prepare a story about a woman who became pregnant without wanting to, like those in the previous section. Prepare a Problem Tree and write "unintended pregnancy" on the trunk, and "unsafe abortion," "safe abortion," and "no abortion" on the branches.

  1. Introduce the activity and tell the story you have prepared.
  2. Then ask the group, "Why did the woman become pregnant without intending to?" As people say different causes, write them on pieces of paper and stick them next to the roots. Help the group think of ideas that relate to the different root causes. (If necessary, tell more than one story.) Remember: put the "causes" papers that are similar on the same root to make it easier to see the different causes of unintended pregnancy.
  3. Mention that the woman in the story had 3 options, which are on the branches of the tree: unsafe abortion, safe abortion, or no abortion.
  4. Ask the group to discuss what might happen to the woman with each option. Some questions to ask:
    • How do you think the woman’s life will change if she does not have an abortion and gives birth to the child?
    • What could happen to the woman if she has an unsafe abortion?
    • What could happen to the woman if she has a safe abortion?

    Write the answers on pieces of paper and put these "leaves" on the option branches.

    People may name good and bad things that could result from each option. If you have paper of different colors, you can make 2 different kinds of leaves, one color for the good things and another color for the bad things.

  5. illustration of the above: a problem tree about unintended pregnancy.
  6. To conclude, ask the group to think of ways that things could change. For example, you could ask, "What could be done so that the tree would have healthier, more positive leaves on all of the branches?" or ask the group how to address the root causes of unintended pregnancy.

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Remember that unintended pregnancy is not always a problem. Many women accept it and never think about having an abortion. Many women who do not want to be pregnant also do not want to have an abortion, no matter how much having the child will change their plans and their lives.