Research and programs for female sex workers (FSWs) tend to focus exclusively on HIV prevention, with little attention paid to how pregnancy affects their lives. We examine the circumstances surrounding pregnancy and childbirth among women selling sex in Ethiopia. In Adama City, researchers asked 30 FSWs aged 18 and older who had ever been pregnant to participate in in-depth interviews. The women reported on pregnancies experienced both before and after they had begun selling sex. They identified some of the fathers as clients, former partners, and current partners, but they did not know the identities of the other fathers. Missed injections, skipped pills, and inconsistent condom use were causes of unintended pregnancy. Abortion was common, typically with a medication regimen at a facility. Comprehensive sexual and reproductive health services should be provided to women who sell sex, in recognition and support of their need for family planning and their desire to plan whether and when to have children.
Published in a peer-reviewed journal of the Population Council. Eileen A. Yam is Associate, Brady Burnett-Zieman is Staff Associate, and Nanlesta Pilgrim is Associate, Population Council. Aklilu Kidanu is Director, Miz-Hasab Research Center, Addis Ababa, Ethiopia. Jerry Okal is Associate, Population Council, Nairobi, Kenya. Assefa Bekele is Adama Branch Manager and Daniel Gudeta is Project Coordinator, Link Up, Organization for Social Services, Health and Development, Addis Ababa, Ethiopia. Georgina Caswell is Regional Advisor, Link Up, International HIV/AIDS Alliance, Cape Town, South Africa.