Key Social Norms Take-aways Adolescent girls and young women (AGYW) in Benin navigate abortion decisions and care in a context of profound normative pressure, shaped by a “triple normative burden”: the stigmatization of premarital pregnancy, lack of access to comprehensive sexuality education, and strong moral and religious condemnation of abortion. These norms are reinforced by family expectations, religious doctrine, restrictive social roles, and the attitudes of healthcare providers. Together, they create a context in which even legally permissible abortion is constrained by secrecy, shame, and fear. The study highlights that social norms operate not only as external expectations but are internalized by AGYW, who often carry feelings of guilt and responsibility, limiting their ability to claim care or assert reproductive agency.
Objectives To examine how social and gender norms influence the abortion experiences and decision-making processes of adolescent girls and young women in Benin, particularly in relation to care-seeking pathways and agency prior to the 2021 legal reform expanding abortion access.
Methods A six-month ethnographic study was conducted in Benin’s Atlantique department, combining participant observation in healthcare settings, 28 in-depth interviews with AGYW who had abortions, 18 interviews with their relatives and partners, 20 key informant interviews (including religious leaders, health professionals, and local officials), and 42 focus group participants (adolescents and parents). Thematic analysis was guided by a socio-ecological model and a social norms taxonomy tailored for West Africa.
Results AGYW’s abortion trajectories were shaped by intersecting norms across multiple layers of their environment. Premarital pregnancy was seen as dishonorable, damaging marriage prospects and family reputation. Mothers were key influencers in abortion decision-making, yet their own adherence to moral norms often led to secrecy or delayed care. Male partner involvement sometimes facilitated access to safer services, though it also reinforced unequal gender dynamics. Health providers, influenced by religious and moral convictions, often judged or refused care, contributing to unsafe abortions. Despite their vulnerability, AGYW demonstrated strategic agency—navigating care discreetly, relying on peer networks, or self-managing abortion—while carrying heavy emotional and social burdens.
Conclusions Legal reform alone is insufficient to ensure safe and equitable abortion access for AGYW in Benin. Meaningful change requires addressing the deep-rooted gender and social norms that stigmatize adolescent sexuality, constrain reproductive choices, and silence young women’s voices. Multilevel interventions must engage families, communities, religious leaders, and health providers to create supportive environments that center young women’s dignity, agency, and rights.