Opposition to abortion is grounded in cultural, religious and individual values, resulting in laws and practices that restrict or deny access to safe abortion. Nevertheless, abortion continues to occur in all nations, regardless of legal frameworks, because women will find means to terminate pregnancies that are unwanted. There is a significant body of evidence demonstrating that restrictive legal frameworks do not deter women from having abortions but increase the likelihood of unsafe abortions. Despite this evidence, women and couples continue to be denied their reproductive right to determine if and when they have a child. For example, culturally, it is argued that abortion is a ‘foreign’ practice.87 In Africa, children belong to the society and women should not be given the autonomy in making abortion decisions. Many religious groups argue that a foetus also has a ‘right to life’ and therefore deem termination of pregnancy unacceptable.

Even when abortion is legal, there are still many barriers to access, as indicated by WHO:88

  • Despite the right under law, many countries have not made provisions, or have insufficient provisions, for abortion services; this is often due to social and cultural beliefs related to abortion.
  • A lack of awareness regarding what the law permits among professionals in the public, legal and health sectors.
  • Unwillingness among policy-makers and health professionals to implement abortion laws and acknowledge that women have a legal right to abortion under certain circumstances.
  • Women are not being informed of their rights under the law and may be unaware of the conditions under which they are entitled to access abortion services.
  • Social and cultural beliefs regarding abortion, and fear of ill-treatment and legal reprisals, may prevent women from seeking care.
  • Official abortion services are too costly, requiring a fee that many cannot afford.
  • Abortion service facilities are not well distributed throughout the country.
  • Abortion services may be insufficient to meet the demand.
  • Abortion services may be of poor quality.
  • The attitudes of medical staff may be discouraging and women may be exposed to abuse or ill-treatment.

Lack of access to safe abortion can affect all women and couples. However, adolescent girls are disproportionately affected for a range of reasons. For example, adolescent girls may be more likely to have unplanned pregnancies due to diminished power to say no to sex. Furthermore, poor access to reproduction facts, contraceptives or inability to negotiate contraceptive use can result in higher chance of pregnancy. In many contexts adolescent girls who are not yet married may suffer severe consequences if they fall pregnant including social stigmatisation and loss of educational and employment opportunities. Therefore, there may be greater incentive for adolescent girls to seek out abortion than other women.

As is the case with information related to SRHR in general, sport programmes have the opportunity to provide valuable information on abortion, refer participants to safe abortion services and educate girls and young women on the dangers of unsafe and unauthorised abortion services. Sport programmes also can link participants to counselling services for effective post abortion care. In addition, creating non-judgemental environments helps adolescent girls deal with the emotional and physical effects of abortion, by confiding in and gaining strength from their teammates and coaches/mentors.

Useful Example – Reducing Unsafe Abortions
Founded in 1973, Ipas is a global nongovernmental organisation dedicated to ending preventable deaths and disabilities from unsafe abortion. Through local, national and global partnerships, Ipas works to ensure that women can obtain safe, respectful and comprehensive abortion care, including counselling and contraception to prevent future unintended pregnancies. In Nigeria, Ipas aired radio jingles with reproductive health messages for four months and conducted training with pharmacists on how to effectively provide information on medical abortion to adolescents and young women as a strategy to reduce maternal morbidity and mortality rates due to unsafe abortion practice. Ipas also conducted six community discussions on sexual and reproductive health and rights of young women.

Abortion Care for Young Women
This training toolkit is designed to provide information and guidance on ensuring access to appropriate induced abortion care for young women (ages 10-24). It provides experienced trainers with the background information, materials, instructions and tips necessary to effectively facilitate training sessions. Since existing research demonstrates few differences in the clinical needs of young women compared to adults, the toolkit also contains more information on advocacy, partnerships and service delivery than clinical issues. It is a global resource for health care providers, trainers, administrators and technical advisors of abortion care programmes, but some materials also can be used to engage young people, policymakers, community groups, donors, advocates and other stakeholders.

Adolescent Girl Life Skills: