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ORIGINAL RESEARCH article

Front. Reprod. Health

Sec. Adolescent Reproductive Health and Well-being

Volume 7 - 2025 | doi: 10.3389/frph.2025.1643865

This article is part of the Research TopicAdolescent Oral, Mental and Sexual WellnessView all 6 articles

‘Better she gets infected by other diseases but not pregnancy’. Narratives from adolescent girls and community males on pregnancy escalation during COVID-19 lockdown.

Provisionally accepted
  • 1Liverpool School of Tropical Medicine, Liverpool, United Kingdom
  • 2Nyanza Reproductive Health Society, Kisumu, Kenya
  • 3University of Illinois, Chicago School of Public Health, Chicago, United States
  • 4Rush University Rush Medical College, Chicago, United States

The final, formatted version of the article will be published soon.

ABSTRACT Adolescent sexual and reproductive health in low- and middle-income countries is critical to address following the COVID-19 pandemic. Growing evidence of its’ impact includes increased teenage pregnancies and higher rates of unsafe abortion. Our qualitative study sought to understand perspectives and behaviours around these escalations. Using random sampling we conducted focus group discussions with adolescent girls and young women (AGYW) from western Kenya to understand perceptions and behaviours that drove high rates of pregnancy and abortion. Alongside, male opinions were sought using opportunistic sampling to recruit participants. Six FGDs with AGYW (n=54) and five with community males (n=53) were conducted with data analysed using thematic analysis. Results were grouped under 4 themes: 1) Fear, responsibility and blame; 2) Drivers of abortion; 3) Accessing an abortion; 4) Family planning including condom use. AGYW narratives revealed a dread of unintended pregnancy fearing parental and community reactions whilst men feared unfair blame from the community for impregnating AGYW despite admissions of sexual relationships with schoolgirls. Abortion attempts were common, girls described clandestine bids, including ingestion of dangerous or ineffective products, methods corroborated by the men. Many participants, male and female did nothing to mitigate pregnancy risks, disliking condoms and perceiving family planning as a threat to future fertility, or giving license to girls’ promiscuity. Consequently, AGYW remain at high pregnancy and unsafe abortion risk until community attitudes and knowledge are challenged. Our findings highlight the need for information and education to dispel myths and misinformation regarding family planning methods, and address inequities in gender norms. Safe, legal and affordable abortion is also paramount. Follow-up is required to assess long term physical and psychological consequences of the high number of unwanted pregnancies and abortions, particularly amongst those who had a failed abortion.

Keywords: qualitataive analysis, Pregnancy, Abortion, AGYW, Kenya, Family Planning (FP), Males & females

Received: 09 Jun 2025; Accepted: 05 Aug 2025.

Copyright: © 2025 Mason, Awiti, Young, Otieno, Zulaika, Phillips-Howard and Mehta. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Linda Mason, Liverpool School of Tropical Medicine, Liverpool, United Kingdom

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