Knowledge of Abortion Laws and Policies and Abortion Choices among Women in Bungoma County, Kenya

Access to accurate information on abortion laws and policies plays a critical role in shaping women’s reproductive health decisions. In Kenya, uncertainty and misconceptions regarding the legal provisions governing abortion continue to influence women’s choices, often resulting in unsafe abortion practices. This study sought to examine the effect of knowledge of abortion laws and policies on abortion choices among women in Bungoma County. The study was guided by the Health Belief Model, which emphasizes the influence of perceived knowledge and awareness on individual health-related decisions. A descriptive research design was adopted, targeting 78 young women aged 18–24 years, 10 Kenya Registered Nurses, and 10 gynecologists. Data from the women were collected using structured questionnaires administered through snowball sampling, while key informant interviews were conducted with nurses and gynecologists. Quantitative data were analyzed using the Statistical Package for Social Sciences, while qualitative data were analyzed thematically using Nvivo. The findings revealed that knowledge of abortion laws and policies had a strong positive influence on abortion choices among young women, with those possessing accurate legal awareness more likely to seek safe and medically supervised abortion services. Limited knowledge and prevailing misinformation, however, contributed to continued reliance on unsafe abortion methods driven by fear of legal repercussions, stigma, and social pressure. The study concludes that enhancing women’s knowledge of abortion laws is essential in promoting informed, safe, and health-conscious reproductive choices. It recommends that health facilities, county reproductive health programs, and community actors intensify targeted awareness campaigns, youth-friendly counseling, and policy dissemination to reduce unsafe abortion practices and improve reproductive health outcomes.

Abortion Laws, Reproductive Health, Abortion Choices

1. Aftab, W., Siddiqui, F. J., Tasic, H., Perveen, S., Siddiqi, S., & Bhutta, Z. A. (2020). Implementation of health and health-related sustainable development goals: progress, challenges and opportunities–a systematic literature review. BMJ global health, 5(8), e002273. [Google Scholar] [Crossref]

2. Ahmed, I., & Ishtiaq, S. (2021). Reliability and Validity: Importance in medical research. Methods, 12(1), 2401-2406. [Google Scholar] [Crossref]

3. Atuhaire, S. (2019). Abortion among adolescents in Africa: A review of practices, consequences, and control strategies. The international journal of health planning and management, 34(4), e1378-e1386. [Google Scholar] [Crossref]

4. Blaylock, R., Makleff, S., Whitehouse, K. C., & Lohr, P. A. (2022). Client perspectives on choice of abortion method in England and Wales. BMJ Sexual & Reproductive Health, 48(4), 246 251. [Google Scholar] [Crossref]

5. Bronfenbrenner, U. (1994). Ecological models of human development. International encyclopedia of education, 3(2), 37-43. [Google Scholar] [Crossref]

6. Chigbu, C. C., Chigbu, C. O., Iwuji, S. E., Emenalo, F. C., & Onyebuchi, A. K. (2018). Impact of abortion laws on women's choice of abortion service providers and facilities in southeastern Nigeria. Nigerian Journal of Clinical Practice, 21(9), 1114-1120. [Google Scholar] [Crossref]

7. Coleman, P. B. (Ed.). (2020). Practical sampling techniques for infrared analysis. CRC Press. [Google Scholar] [Crossref]

8. Connell, J. P., & Kubisch, A. C. (1998). Applying a theory of change approach to the evaluation of comprehensive community initiatives: progress, prospects, and problems. New approaches to evaluating community initiatives, 2(15-44), 1-16. [Google Scholar] [Crossref]

9. Denno, D. M., Plesons, M., & Chandra-Mouli, V. (2021). Effective strategies to improve health worker performance in delivering adolescent-friendly sexual and reproductive health services. International Journal of Adolescent Medicine and Health, 33(6), 269-297. [Google Scholar] [Crossref]

10. Funnell, S. C., & Rogers, P. J. (2011). Purposeful program theory: Effective use of theories of change and logic models (Vol. 31). John Wiley & Sons. [Google Scholar] [Crossref]

11. Hechter, M., & Kanazawa, S. (1997). Sociological rational choice theory. Annual review of sociology, 23(1), 191-214. [Google Scholar] [Crossref]

12. Hudik, M. (2019). Two interpretations of the rational choice theory and the relevance of behavioral critique. Rationality and Society, 31(4), 464-489. [Google Scholar] [Crossref]

13. Jozkowski, K. N., Crawford, B. L., & Hunt, M. E. (2018). Complexity in attitudes toward abortion access: results from two studies. Sexuality Research and Social Policy, 15, 464-482. [Google Scholar] [Crossref]

14. Kabiru, C. W., Ushie, B. A., Mutua, M. M., & Izugbara, C. O. (2016). Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis. BMC pregnancy and childbirth, 16, 1-10. [Google Scholar] [Crossref]

15. Kisiangani, P. O., Sakwa, G., & Arudo, J. (2019). Determinants of Maternal and Child Health Care Services Utilization among Mothers of Mount Elgon Constituency Bungoma, Kenya. Global Journal of Health Sciences, 4(2), 23-40. [Google Scholar] [Crossref]

16. Liang, M., Simelane, S., Fillo, G. F., Chalasani, S., Weny, K., Canelos, P. S., ... & Snow, R. (2019). The state of adolescent sexual and reproductive health. Journal of Adolescent Health, 65(6), S3-S15. [Google Scholar] [Crossref]

17. Maynard‐Moody, S., & Portillo, S. (2010). Street‐level bureaucracy theory. [Google Scholar] [Crossref]

18. Miller, S., Wherry, L. R., & Foster, D. G. (2023). The economic consequences of being denied an abortion. American Economic Journal: Economic Policy, 15(1), 394-437. [Google Scholar] [Crossref]

19. Moore, S. T. (1987). The theory of street-level bureaucracy: A positive critique. Administration & Society, 19(1), 74-94. [Google Scholar] [Crossref]

20. Munakampe, M. N., Zulu, J. M., & Michelo, C. (2018). Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review. BMC health services research, 18, 1-13. [Google Scholar] [Crossref]

21. Mwongeli, M. (2022). Exploring the Socio-economic and Information Determinants of Teenage Pregnancy in Webuye West Sub-county, Bungoma County, Kenya (Doctoral dissertation, University of Nairobi). [Google Scholar] [Crossref]

22. Nyaboke, A. A. (2020). Socio-Economic Factors Contributing to Increase in Cases of Teenage Pregnancy in Public Secondary Schools in Kanduyi Sub-County Bungoma County, Kenya. [Google Scholar] [Crossref]

23. Okenyoru, D. S., Matoke, V., Wekesa, C., Murugi, L., Odhiambo, F., & Kemboi, S. J. (2024). Socio-demographic factors influencing abortion practices among women attending Mbagathi Hospital, Nairobi County, Kenya. International Journal of Community Medicine and Public Health, 11(10), 3787. [Google Scholar] [Crossref]

24. Osborne, D., Huang, Y., Overall, N. C., Sutton, R. M., Petterson, A., Douglas, K. M., ... & Sibley, C. G. (2022). Abortion attitudes: An overview of demographic and ideological differences. Political Psychology, 43, 29-76. [Google Scholar] [Crossref]

25. Report sees high abortions among Nairobi, Bungoma youth. (2020, July 7). The Star. https://www.the-star.co.ke/news/2020-07-07-report-sees-high-abortions-among-nairobi-bungoma-youth/ [Google Scholar] [Crossref]

26. Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: appropriate use and interpretation. Anesthesia & analgesia, 126(5), 1763-1768. [Google Scholar] [Crossref]

27. Sileyew, K. J. (2019). Research design and methodology (Vol. 7). Cyberspace. [Google Scholar] [Crossref]

28. Surucu, L., & Maslakci, A. (2020). Validity and reliability in quantitative research. Business & Management Studies: An International Journal, 8(3), 2694-2726. [Google Scholar] [Crossref]

29. White, K. O., Jones, H. E., Lavelanet, A., Norman, W. V., Guilbert, E., Lichtenberg, E. S., & Paul, M. (2019). First-trimester aspiration abortion practices: a survey of United States abortion providers. Contraception, 99(1), 10-15. [Google Scholar] [Crossref]

30. World Health Organization. (2022). Abortion care guideline: executive summary. World Health Organization. [Google Scholar] [Crossref]

31. World Health Organization. (2022). Global oral health status report: towards universal health coverage for oral health by 2030. World Health Organization. [Google Scholar] [Crossref]

32. World Health Organization: WHO. (2024, May 17). Abortion. https://www.who.int/news-room/fact-sheets/detail/abortion [Google Scholar] [Crossref]

• Migrant Health in Morocco: Between Law and Reality
• CaknaMinda: An Educator-Centred Mobile App for Early Screening of Mental Health and Schizophrenia Risks
• Health System and Nursing Strategies for Enhancing Male Participation in Family Planning: Evidence from Tema General Hospital, Ghana.
• From Īśvara-Praṇidhāna to Parā-Bhakti: Convergent Paths of Aṣṭāṅga Yoga and Bhakti Yoga
• Evidence-Based Psycho-Oncological Interventions: A Multimodal Approach to Supportive Care