Social Network Involvement in Abortion Care‐Seeking and Abortion Outcomes among a Population‐Based Sample of Nigerian Women Who Had Abortions

Abstract

People often engage social networks when navigating abortion access constraints, but limited research links this involvement to abortion outcomes. This cross‐sectional study analyzed PMA2020 data from 1,144 women in Nigeria who had abortions, identified through population‐based surveys and abortion‐focused follow‐ups conducted in 2018 and 2019–2020, respectively. We examined how social network involvement in care‐seeking—specifically, in method or provider selection—related to abortion outcomes: medically defined abortion safety, use of preferred method and provider, and success of the initial abortion attempt. Social network involvement was common (63 percent) and varied across sociodemographic groups. Outcomes differed by involvement source: when both partners and family/friends were involved, women were least likely to have the least safe abortions (23.9 percent vs. 60.9 percent, p < 0.001) or make multiple abortion attempts (13.7 percent vs. 19.1 percent, p = 0.009), though they were equally likely to use preferred care as those seeking care alone. Partner‐only involvement was also significantly associated with fewer least safe abortions (36.3 percent vs. 60.9 percent, p < 0.001), while family/friend‐only involvement was significantly associated with non‐preferred abortion options (36.6 percent vs. 21.6 percent, p < 0.001) and more repeated attempts (27.8 percent vs. 19.1 percent, p = 0.038). These findings suggest that social networks have the potential to improve or worsen abortion outcomes, with important variation across person‐centered measures of abortion experiences.