“There was No Alternative Choice” – Australian Migrant Youth’s Abortion Decision-making and Experiences

Introduction: Decision-making and experiences of accessing abortion are complex, shaped by myriad intersecting personal, relational, social and structural factors. While abortion is decriminalised in Australia, there is limited information on the experiences of immigrant groups. Migrant youth have lower sexual health knowledge and service uptake than mainstream Australian youth and may have higher rates of unplanned pregnancy and contend with prevalent abortion stigma within their communities. Methods: This study investigated abortion experiences and decision-making of Australian migrant youth, following a qualitative approach using in-depth semi-structured interviews. Interviews were conducted online between May and September 2023. Interviews were recorded and transcribed verbatim, and anonymised. Reflexive thematic analysis, with a combination of inductive and deductive methods, was used. Inductive coding was used for initial analysis; following inductive analysis, themes were separated into ‘decision-making’ and ‘experiences’ and organised according to socioecological factors. Results: Participants (n = 8) identified as female and ranged from 19 to 26 years. Young women were South Asian, East Asian, European, and Latin American. Results were presented under two high-level themes – decision-making and experiences – and presented broadly under socioecological factors. Primary decision-making factors included age and unpreparedness; financial concerns; personal values; and relationships. Participants were, largely, satisfied with care. They were deeply grateful for abortion care, and found access relatively easy. However, they experienced significant financial barriers, struggled with stigma and secrecy, and often lacked adequate support systems. Conclusion: Participants navigated intersecting privileges and oppressions including age, gender, migrant identity, and economic status in accessing stigmatised healthcare. Policy Implications: This study highlights the importance of accessible, affordable abortion care. Future care and policy should recognise the agency in migrant youth decision-making, the complex experiences of accessing abortion and the need for greater support for this group.