Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.