Key Social Norms Take-aways This study highlights how deeply embedded gender norms, social stigma, and restrictive abortion laws in Burkina Faso collectively constrain young women’s reproductive autonomy. Abortion decisions are rarely made in isolation and are instead shaped by community actors, intergenerational dynamics, and intimate partner negotiations. Social norms around premarital sex and motherhood create powerful pressures—often intensified through emotional blackmail, religious beliefs, and even coercion or violence—leaving women vulnerable and disempowered in navigating pregnancy decisions. The process is protracted, uncertain, and heavily negotiated, reflecting how social norms render reproductive decision-making a contested and collective act.
Objectives The study aimed to explore how young people in Ouagadougou, Burkina Faso make decisions about abortion in a legally restrictive and socially stigmatizing context. Specifically, it investigated the pathways, actors, and rationales involved in abortion decision-making among young women and their partners.
Methods Researchers conducted ethnographic fieldwork from 2011 to 2014 in three referral health facilities in Ouagadougou, using participant observation and in-depth interviews (IDIs). The sample included 36 young people aged 17–25 (31 women and 5 men). Interviews explored personal, relational, and social dimensions of abortion decisions. An inductive content analysis approach was used to identify decision-making sequences, negotiation patterns, and influencing actors.
Results Abortion decision-making was found to be complex, non-linear, and collective. Women’s decisions were shaped by factors such as relationship stability, economic insecurity, and fears of stigma associated with premarital pregnancy. Negotiations with partners often involved conflict, emotional coercion, or physical force, particularly in cases of disagreement. Religious figures, family members, and peers also influenced outcomes. Many women experienced prolonged decision-making processes, with some being deceived or coerced into abortions. The process was frequently marked by fear—of social condemnation, legal repercussions, or unsafe procedures—and often took place in secrecy and distress.
Conclusions In a setting with highly restrictive abortion laws and strong social norms against premarital pregnancy and abortion, decision-making about abortion is a collective and contentious process. It is shaped by asymmetrical power dynamics and cultural expectations, often leaving young women vulnerable to unsafe abortions and disempowerment. The study underscores the need for legal reforms and community-level interventions to improve reproductive autonomy and reduce harm caused by gendered vulnerabilities and social stigma.