In Nigeria, abortion is illegal except to save a woman’s life, and data on abortion are limited. Performance, Monitoring and Accountability 2020 (PMA2020), in conjunction with the Centre for Research, Evaluation Resources and Development, are collecting nationally-representative survey data on abortion perceptions, norms and stigma in seven states in Nigeria. This study aims to characterize abortion stigma and its correlates, and assess its relationship to perceptions of abortion in the community and the performance of survey-based abortion estimation techniques.
Using a two-stage cluster design, women aged 15-49 in households are interviewed by resident enumerators using smartphones. Women are asked about a range of reproductive health issues, including their perceptions and experiences around abortion, as well as those of their closest confidantes. Survey administration will be complete in May 2018 with a final sample of approximately 11,000 women. Here we report on preliminary analyses of bivariate associations and estimates of lifetime abortion experience. Multivariate regression analysis will be conducted upon attainment of the final sample.
Overall, approximately 70% of respondents felt that a woman who has an abortion brings shame to her family, and 45% reported abortion as common. A higher percentage of women who perceived abortion as shameful reported it as uncommon compared to women who didn’t perceive it as such (47% vs 43%, p<0.001). Estimates of reported lifetime prevalence of a likely abortion amongst a woman’s closest confidante were lower among women who perceived abortion as stigmatized versus not stigmatized (18% vs 22%, p<0.05). We recorded a difference in self-reported lifetime likely abortion prevalence among women who perceived abortion-related stigma versus those who did not (13% vs 17%, p<0.001).
Our study incorporates data on stigma, perceptions of abortion prevalence, and two methodologies (self-report and confidante) for abortion estimation, allowing consideration of the empirical associations between stigma and these measures.