A new report released today from Promundo and the International Center for Research on Women (ICRW) sheds new light on how stigma, social norms and masculine stereotypes influence men’s involvement in decision-making and behavior around abortion with their partners.

In India, unsafe abortion is the third leading cause of maternal death and it contributes 8 percent to all such deaths each year. Even though unmarried women in India have the legal right to abortion, they face challenges because of the secrecy, shame and stigma associated with premarital sex and abortion, in addition to difficulties accessing information and services.

In light of these challenges, as well as a lack of existing research on the abortion journeys of young men and women outside of marriage, Promundo and ICRW conducted a qualitative study to investigate young men’s attitudes, perceptions and experiences as partners in relation to premarital abortion in New Delhi.

The study included in-depth interviews with young women seeking abortions and their male partners, six focus group discussions with young men and young women and key informant interviews with experts and service providers in New Delhi in 2018. To unpack the socio-economic factors that influence the perceptions, attitudes and experiences of young people, participants were recruited from diverse socio-economic contexts.

“For too long, oppressive gender norms have forced women to carry the burden of reproductive health care,” said Sapna Kedia, ICRW technical specialist and lead author of the study. “Our study shows that men want to support their partners when it comes to decisions around contraception and pregnancy. When we engage with men around pregnancy and abortion, we improve sexual and reproductive rights for all.”

Watch Sapna discuss the findings with ICRW Asia Regional Director Ravi Verma. 

The research revealed a number of common themes among the study participants:

• Access to non-judgmental medical advice and psychosocial help or counseling is not available for most young people seeking abortion care. Anxiety and guilt caused by stigma associated with premarital sex, post barriers for young people seeking abortion care. Little or no sex education ensure that they have little to no knowledge about reproductive health. Lack of open communication and support systems cause young people to rely upon their peers’ ill-informed, incomplete and dated information, which leads to greater health risks and trauma.

• Men can leverage their social privilege to support their partners in premarital abortion seeking. Male study participants – acting from a position of societal privilege that affords them greater mobility and autonomy – reported acting as an “all-in-one service provider” for their partners. They sought information about pregnancy kits, abortion pills and clinics; where needed, they purchased medication, spoke to doctors, accompanied their partners to the clinics and paid for the abortion.

• Male support for their partners is driven by gender stereotypes that men are the provider and caretaker in relationships, along with a concern for their partners’ well-being. Male participants thought it was their responsibility to preserve and protect their partners’ reputations and honor and so they felt duty-bound to support them during the abortion process.

• A key factor that shapes men’s involvement in seeking an abortion is their own shame and stigma associated with premarital sex. Male participants reported feeling guilt, shame and fear for having put their partners in the situation of needing an abortion – either propelling them to stay with their partners and offer support or to end the relationship and disappear.

• Medical providers also propagate stigma around abortion. This acts as a barrier to young men and women using safe, non-judgmental abortion services and forces them to resort to less reliable or even unsafe methods. Participants reported perceiving that health facilities exclude men at the time of an abortion procedure. As a result, male partners often prefer to stay outside the medical premises.

“With women’s reproductive rights and bodily autonomy under attack in many countries around the world, this study sheds light on opportunities to improve the quality of and expand access to safe, legal abortion care,” says Jane Kato-Wallace, Director of Programs, Promundo, “Though only conducted in India, the study’s results affirm much of what we already know: that many men can and already do care about supporting the full spectrum of women’s reproductive health and rights, and we should do more to engage them intentionally in our advocacy efforts.”

The findings reveal opportunities to engage with men to expand access sexual and reproductive health and rights for both men and women. Recommendations include:

• Discuss men’s roles as participants in and supporters of sexual and reproductive health and rights (SRHR): Men’s roles are often neglected in discussions around sexual and reproductive health. The study shows that many men are willing to share the burden of premarital pregnancy and/or abortion with their partners.

• Leverage men’s capacity as information seekers and providers: Engaging men as seekers, carriers and disseminators of information can encourage communication on these issues, promote contraceptive use and positively influence safe abortion practices.

• Work with men to address harmful gender norms: Gender norms have a strong bearing on decisions made about premarital sex and abortion. Encouraging men to respect women, promote equal decision-making and challenge attitudes that cause sexual and gender-based violence and inequality is critical.

• Encourage service providers’ positive interactions with men: Healthcare providers’ perceptions, attitudes and practices can substantially affect access to and quality of abortion services. By engaging with men positively, they can improve a woman’s abortion journey, as well as help address men’s specific concerns about safe sexual behavior.

Men can and must play an important role in affirming women’s access to safe abortion care, as well as be allies in securing full and equal rights for women. In addition to the potential benefits for individual women, men’s involvement as advocates may, at a broader level, advance women’s access to safe abortion and quality care by reducing stigma. Safe abortion with dignity is every woman’s right and is a key pillar of a comprehensive SRHR rights platform.

Read the full report here.