Homeless Youth and Abortion: Results from a Qualitative Study

Background: Compared to their housed counterparts, youth experiencing homelessness demonstrate exceptionally high pregnancy rates. Some homeless youth choose to end their pregnancies by obtaining abortions. However, research is scarce pertaining to this population’s abortion attitudes and experiences. Furthermore, several preliminary studies have indicated that some homeless youth attempt self-induced abortions, and do so using dangerous strategies. This study thus explores, in greater detail than prior research, homeless youths’ experiences, attitudes, and decision-making regarding abortion, including self-induced abortion.

Methods: Phenomenological qualitative data were collected from individual interviews with 30 female, male, and gender-fluid homeless youth, ages 18 to 21, who were residing at a youth-serving shelter. Using a semi-structured interview guide, a range of family planning topics, including abortion, were explored. Qualitative transcripts were independently analyzed by two coders, to increase rigor and reduce bias in analyses. To comprehensively, yet concisely, summarize homeless youths’ lived experiences regarding abortion and related family planning topics, transcripts underwent three rounds of coding: 1) initial “open” coding; 2) holistic, “middle-order” coding; and 3) final, “focused” coding.

Results: Youth noted that abortions, obtained in the formal medical system, are common among this population. Of particular concern, however, most respondents also knew of other young homeless individuals who had attempted and/or completed self-induced abortions using unsafe methods. Moreover, several respondents recounted stories of their own abortion self-induction attempts while experiencing homelessness. The majority of respondents did not know where and how to access abortions safely, feared abortion-related stigma, and reflected inaccurate perceptions regarding abortion cost and legality.

Implications: Findings suggest that many homeless youth hold considerable misperceptions regarding the accessibility and cost of abortion services offered in the formal medical system. Respondents also noted an alarmingly high frequency of abortion self-induction strategies employed by this population, which they attributed to commonly-held beliefs among homeless youth that such services are neither affordable nor accessible to them. Results from the current study thus indicate an urgent need to further develop culturally responsive prevention and family planning outreach for this uniquely vulnerable population.