ABSTRACT

Background: Abortion among adolescents remains a major public health concern, particularly in developing countries where unintended pregnancies and unsafe abortion practices are common. Adolescents often face challenges such as limited knowledge, negative perceptions, and socio-economic pressures that influence their decisions regarding abortion. This study aimed to assess the knowledge, perception, and social and economic factors influencing abortion among adolescents in the Muea community.

Methods: A descriptive cross-sectional study design was used among adolescents in the Muea community. Data were collected using structured questionnaires administered to respondents selected through a convenient sampling technique. The data were analyzed using descriptive statistics including frequencies and percentages and presented in tables and charts.

Results: The findings revealed that all respondents (100%) had heard about abortion, with the majority (82%) correctly identifying abortion as termination of pregnancy. Most adolescents (67%) perceived abortion as unacceptable, and 84% considered abortion a sin. However, some respondents (39%) indicated that they would consider abortion if faced with an unwanted pregnancy. Social factors such as fear of parents (40%), fear of school dropout (22%), and stigma influenced abortion decisions. Economic factors including financial dependence (40%) and lack of partner support (20%) also played significant roles.

Conclusions: The study concluded that although adolescents in the Muea community had good knowledge of abortion, negative perceptions and socio-economic factors significantly influenced abortion decisions. Strengthening reproductive health education, improving parent–adolescent communication, and providing youth-friendly services are essential to reduce unintended pregnancies and unsafe abortion practices among adolescents.

Keywords: Adolescents, Abortion, Knowledge, Perception, Socio-economic factors, Muea Community

CHAPTER ONE

GENERAL INTRODUCTION

Background of study

Adolescence is a critical stage of human from aged 15-19 years development characterized by physical, emotional, and social changes. During this period, many adolescents begin to explore their sexuality, often with limited access to accurate sexual and reproductive health information and services. As a result, adolescents are at increased risk of unintended pregnancies, which may lead to induced abortion, especially in settings where contraceptive use is low or inconsistent.

Globally, adolescent pregnancy remains a major public health concern (Njim,T.,Agbor,V.N.,&Njim,E. 2018). According to the World Health Organization, millions of girls aged 15–19 experience unintended pregnancies each year, and a significant proportion of these pregnancies end in abortion. In many low- and middle-income countries, including those in sub-Saharan Africa, restrictive abortion laws, social stigma, and cultural and religious beliefs often push adolescents to seek unsafe abortion methods, thereby increasing the risk of complications such as hemorrhage, infection, infertility, and even death.

Perception plays a crucial role in adolescents decisions regarding abortion. Adolescents views about abortion are shaped by various influences, including family values, peer pressure, religious teachings, cultural norms, level of education, and exposure to media (Koiwa, Shishido, & Horiuchi, 2024 ). Negative perceptions and misconceptions about abortion may prevent adolescents from seeking safe reproductive health services, while fear of parental reaction and societal judgment often leads to secrecy and unsafe practices. (Koiwa et al., 2024).

Several factors influence adolescents decision to terminate a pregnancy(koiwa,Y.,Shishido,E.&Horiuchi,S.,2024).These factors include socioeconomic status, lack of parental support, fear of school dropout, unstable relationships, sexual violence, poor access to contraceptives, and inadequate sexual health education. In addition, health system factors such as limited youth-friendly services and lack of confidentiality further contribute to adolescents vulnerability.

Despite the serious health and social consequences associated with adolescent abortion, there is limited empirical data on adolescents perceptions and the specific factors influencing abortion decisions in many communities. (Koiwa et al., 2024) Understanding these perceptions and factors is essential for designing effective interventions, policies, and reproductive health programs aimed at preventing unintended pregnancies and reducing unsafe abortions among adolescents.

Furthermore, global evidence shows that adolescents’ decisions regarding abortion are strongly influenced by gender norms and power dynamics within relationships. In many settings, adolescent girls have limited autonomy in negotiating contraceptive use or refusing sexual advances, which increases their vulnerability to unintended pregnancy and subsequent abortion. Male partner influence, including denial of responsibility or pressure to terminate a pregnancy, has also been identified as a significant factor shaping adolescents’ abortion decisions.

Media exposure and digital technology increasingly play a role in shaping adolescents’ perceptions of abortion worldwide. While access to the internet and social media can provide valuable reproductive health information, it may also expose adolescents to misinformation, fear-inducing narratives, or unsafe abortion methods. In contexts where comprehensive sexuality education is lacking, adolescents may rely on unverified online sources or peers, further increasing the risk of unsafe abortion practices.

In Africa, abortion has existed in many societies long before the advent of modern medicine. In many pre-colonial African communities, traditional methods were used to terminate pregnancies.(WHO 2012). These practices were often carried out secretly and were guided by cultural beliefs, traditional healers, and indigenous knowledge systems. (Guttmacher Institute, 2023) Although adolescent pregnancy occurred, it was generally discouraged, especially outside marriage, due to strong cultural values emphasizing chastity and family honor. (practices in Africa, 2019)

With the advent of colonial rule in Africa, Western legal and religious systems were introduced. Colonial administrations imposed restrictive abortion laws largely influenced by European moral, legal, and Christian doctrines. These laws criminalized abortion except in very limited circumstances, such as to save the life of the mother. (WHO 2025) As a result, abortion became illegal in most African countries, a situation that persists in many nations today. These restrictions disproportionately affected adolescents, who often lacked the autonomy, resources, and support to manage unintended pregnancies.

In the post-independence era, rapid urbanization, changing social norms, increased school enrollment of girls, and delayed marriage contributed to a rise in premarital sexual activity among adolescents. However, access to comprehensive sexual education and contraceptive services remained limited. (Guttmacher Institute 2018). This mismatch led to increased rates of unintended pregnancies among adolescents, many of which resulted in unsafe abortions due to restrictive laws, stigma, and fear of disclosure.

In Cameroon, abortion has long been a sensitive and complex public health and social issue, (Hollander, 2003 Bmc women’s health study),shaped by legal restrictions, cultural norms, religious beliefs, and limited access to reproductive health services. Historically, abortion has been legally restricted and is only permitted under narrow circumstances: to save the life of the woman, to protect her physical or mental health, or in cases of rape. However,the application of these provision is inconsistent,and many who are legally eligible rarely receive safe procedures due to lack of awareness or implementation of the law. (Pmc study 2018)

Research dating back to the late 1990s and early 2000s highlighted that induced abortion was already widespread among young people including adolescents, particularly in urban centres such as Yaoundé (Calves 2002). A demographic study in the capital found that a significant proportion (about 35% of all reported pregnancies) ended in abortion, many of which were carried out under unsafe conditions.

Studies show that, despite legal restrictions and the strong social stigma attached to pre-marital sex and unintended pregnancy adolescents and young women frequently resort to abortion to avoid the social and economic consequences of early or out-of-wedlock childbearing the stigma and cultural norms regarding female sexual behaviour mean that pregnancy outside of marriage is often morally condemned and can lead to isolation, school dropout, or family rejection. As a result, many adolescents conceal their pregnancies and seek clandestine abortions in unsafe conditions. (in Africa review, 2019).

1.2 Problem Statement

Adolescent pregnancy continues to be a significant public health concern globally and in Cameroon due to its high prevalence and the health risks associated with early pregnancies (World Health Organization, 2024; Agbor et al., 2023). Unintended pregnancies among adolescents often lead to considerations of abortion, yet many adolescents face barriers in accessing safe services. Their decisions to terminate pregnancies are influenced by multiple factors, including lack of parental and social support, fear of school dropout, financial constraints, peer pressure, sexual violence, and limited access to contraception (Koiwa, Shishido & Horiuchi, 2024). Cultural, religious, and societal perceptions of abortion further complicate adolescents’ decision-making, often pushing them toward secrecy and unsafe practices.As a result of many adolescents who get involved in pre-marital sex, this result to teenage pregnancy and abortion.

A glaring example was a case of an Adolescent girl who lost her life as a result of a criminal abortion in the Muea community. Thus, investigating the perception and factors influencing abortion among adolescents (15-19) years in Muea community is paramount.

1. 3 Research Questions
2. What knowledge do adolescents in the Muea community have on abortion?
3. What is the perception of adolescents on abortion in the Muea community
4. What are the social and economic factors influencing abortion amongst adolescents in the Muea community?

1.4 Objectives of the study

1.4.1 General Objectives

This study will be aimed at assessing the perceptions and factors influencing abortion amongst adolescents.

1.4.2 Specific objectives

1. To assess the knowledge of adolescents on abortion in the Muea community.
2. To evaluate the perception of adolescent on abortion in the Muea community.
3. To explore the social and economic factors influencing abortion among adolescents in the Muea community.

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