Abstract
Background: Unplanned pregnancy and illegal abortions are two of Namibia's most contentious issues, causing an estimated 12- 16% of maternal deaths. When women, including teenagers, are faced with unintended pregnancies and cannot obtain safe abortions, they often resort to unsafemethods with severe consequences. Restrictive legislation, stigma, strong religious background, and cultural beliefs are barriers to accessing safe abortions. These factors contribute to Namibia's high rate of unsafe abortions. Limited research exists on how women in Namibia perceive abortions and their knowledge of accessing services when needed. This study aims to determine women’s attitudes and knowledge toward the legalization of abortion.
Method: A quantitative cross-sectional design was chosen to gauge women's awareness and attitudes toward abortion legalization in Namibia, focusing on the obstetric and gynecological department of Katutura State Hospital in Windhoek. The study population comprised women aged 18 to 35. Convenience sampling was employed to select a sample of 287 participants. Descriptive statistics such as frequencies and percentages were used to describe the study population. Additionally, a chi-squared test assessed differences in attitudes, knowledge, and sociodemographic factors regarding abortion legalization. Bivariate analysis using crude logistic regression identified variables with p < 0.25 as potential predictors. These variables were included in a multivariate analysis, where those with p < 0.05 at a 95% confidence interval were considered significant predictors of positive attitudes towards abortion legalization.
Results: The study sampled a total of 199 participants, resulting in a response rate of approximately 69.3%. The prevalence of women who supported the legislation of abortion was 48.7% (n=97). A chi-square test analysis revealed statistically significant differences in age, education levels, knowledge about abortion legislation, sources of information, awareness of the legality of abortion in Namibia, and support for women who decide to terminate a pregnancy between those who supported and those who did not support legalization. In the multivariate analysis, significant predictors for being less likely to support abortion legislation included being unsure about the legality of abortion in Namibia (AOR 0.95, 95% CI 0.66-0.97, p=0.000), being unsure about the current abortion law allowing abortion (AOR 0.91, 95% CI 0.56-0.98, p=0.000), being 14 times less likely to utilize legal abortion services (AOR) 0.86, 95% CI 0.78-0.94, p<0.001) and being less inclined to express support for women choosing to terminate a pregnancy (AOR 0.07, 95% CI 0.01-0.13, p=0.028).
Conclusion: This study provides invaluable insights into the complex and polarizing issue of abortion legalization among women in Windhoek, Namibia. The findings reveal a distinct
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divide, with approximately half of the respondents supporting legislative changes to permit abortion and the other half opposing such measures. Crucially, the research highlights the pivotal role of knowledge in shaping women's attitudes towards abortion.