Unmarried women's decisions on pregnancy termination: Qualitative interviews in Colombo, Sri Lanka

Background: In Sri Lanka pregnancy termination is very restricted by law and social norms. Premarital sex, and pregnancies are not generally accepted and unmarried pregnant women are vulnerable in their decision-making on pregnancy termination. Objectives: The objective of this study was to describe the circumstances of becoming pregnant and factors considered in the decision-making for seeking pregnancy termination in a sample of unmarried women in Colombo, Sri Lanka. Methods: Individual qualitative interviews were conducted with 19 unmarried women seeking pregnancy terminations at a reproductive health centre in Colombo, Sri Lanka. The interviews were later analysed using qualitative content analysis. Results: Becoming pregnant in a love relationship was predominant in this sample. Awareness of contraceptives varied and initial reaction to the pregnancy involved strong contradictory emotions. Multiple interrelated factors were considered in the decision-making for termination. Family pressure was the most prominent factor followed by the partner's qualities and attitude towards the pregnancy, economic factors and own feelings, values and future fertility. The women described that their own emotional, religious and economic reasons for continuing the pregnancy were often outweighed by their responsibility to the family, male partner and unborn child. Conclusions: These unmarried women's sexual and reproductive rights were limited and for many the pregnancy termination was socially unsafe. They found themselves at the interface of two value systems. Modern values allow for relationships with men prior to marriage; whereas, traditional values did not. The limited possibilities to prevent pregnancies and little hope for support if continuing the pregnancy; made women seek pregnancy termination despite own doubts. (C) 2010 Elsevier B.V. All rights reserved.