Knowledge and attitudes towards abortion among young adults in Pahang, Malaysia: A descriptive cross-sectional study

Introduction: Abortion remains a sensitive issue in Malaysia due to sociocultural and religious factors. Young adults with limited reproductive health awareness and support are vulnerable to unintended pregnancies and unsafe abortion. Therefore, this study aimed to assess young adults' knowledge and attitudes towards unsafe abortion and their association with sociodemographic characteristics in Kuantan, Pahang. Methods: A descriptive cross-sectional study using stratified random sampling was conducted among 230 young adults aged 15-24 years in Kuantan, Pahang. Data were collected through questionnaires and analysed using the Statistical Package for the Social Sciences version 28.0. Results: Most respondents were aware that unsafe abortions are performed by unskilled individuals and within unsafe environments and include swallowing harmful chemical, inserting foreign objects/substances into the uterus and ingesting caustic substances. The respondents agreed that government-provided abortion services can increase inappropriate sexual behaviours (63.0%) and that legal restrictions can lead to unsafe abortions (61.7%). Many respondents believed that abortion should be allowed for cases including foetal abnormalities (58.4%) and rape (40.9%) but not for Down syndrome (40.4%) and unmarried pregnant adolescents (45.2%). Additionally, age and educational level as well as religion and educational level were associated with knowledge and attitudes towards unsafe abortion, respectively (P<0.05). Conclusion: Enhanced awareness programmes are needed, as many young adults demonstrated knowledge towards unsafe abortion yet mixed attitudes influenced by sociocultural and religious beliefs. Targeted interventions are crucial to address gaps in age, education and religious beliefs for ensuring equitable access to reproductive health services among young adults.