The purpose of this study was to explore the reasons women in rural, southern Gabon, Africa, chose to terminate their pregnancies, the methods used to induce abortions, and post-abortion effects experienced by these women. Abortion is illegal in this country. A descriptive qualitative design guided the methodology for this study. Five women with a history of induced abortion were interviewed in-depth for their abortion story. Reasons cited for an abortion included lack of financial and partner support. Abortion methods included oral, rectal, and vaginal concoctions of leaves, bark, and water and over-the-counter medications, including misoprostol. Affects were physical, spiritual, and relational. Health care professionals need to provide women with guidance for appropriate contraceptive usage. Abortion after-care of women with physical and spiritual needs is important. Future research is suggested on the use of misoprostol in Gabon to understand its affects on women's reproductive health.
"CONTEXT: The incidence of induced abortion and the associated health risks are high in Calabar, Nigeria. There is need to confirm whether all the women subjected to these procedures are really pregnant. OBJECTIVE: To determine what proportion of women seeking abortion services in Calabar were really pregnant. Design and Setting: Cross sectional study on women in Calabar who seek and obtain abortion services. Calabar is the capital of Cross River State in South-Eastern part of Nigeria. SUBJECTS and METHODS: Women who sought and obtained induced abortions in Calabar during the period of study were recruited into the study. The products of conception from the induced abortions were sent for histopathological examinations to confirm whether they were really pregnant. RESULTS: One Hundred and Fifty claimed to be pregnant and procured induced abortions but 17 (11.3%) women were not pregnant from the histological reports of the products of conception. CONCLUSION: A significant proportion of women seeking abortion services in Calabar Nigeria are not pregnant. The routine use of pregnancy tests and/or ultrasonography could prevent a substantial proportion of unnecessary procedures. This will result in reduced health risks and substantial cost saving for women. "
Contraception is an essential element of high-quality abortion care. However, women seeking abortion often leave health facilities without receiving contraceptive counselling or methods, increasing their risk of unintended pregnancy. This paper describes contraceptive uptake in 319,385 women seeking abortion in 2326 public-sector health facilities in eight African and Asian countries from 2011 to 2013. Ministries of Health integrated contraceptive and abortion services, with technical assistance from Ipas, an international non-governmental organisation. Interventions included updating national guidelines, upgrading facilities, supplying contraceptive methods, and training providers. We conducted unadjusted and adjusted associations between facility level, client age, and gestational age and receipt of contraception at the time of abortion. Overall, post-abortion contraceptive uptake was 73%. Factors contributing to uptake included care at a primary-level facility, having an induced abortion, first-trimester gestation, age ≥25, and use of vacuum aspiration for uterine evacuation. Uptake of long-acting, reversible contraception was low in most countries. These findings demonstrate high contraceptive uptake when it is delivered at the time of the abortion, a wide range of contraceptive commodities is available, and ongoing monitoring of services occurs. Improving availability of long-acting contraception, strengthening services in hospitals, and increasing access for young women are areas for improvement.
In Cameroon, induced abortion is permitted when a woman’s life is at risk, to preserve her physical and mental health and on the grounds of rape or incest. Objectives: The aim of this study was to determine the prevalence, reasons and complications of voluntary induced abortion among women attending the obstetrics and gynecology services in an urban area, Yaoundé and in a rural area, Wum in Cameroon. Methods: We carried out a cross sectional study, with 509 women recruited between August 1, 2011 and December 31, 2011 in three health facilities in Cameroon. We appreciated the frequency, complications and reasons for Voluntary induced abortions. Results: The prevalence of voluntary induced abortion was 26.3% (134/509) globally; 25.6% (65/254) in urban area and 27.1% (69/255) in rural area. One hundred and eleven (83%) cases of induced abortions were carried out in a health structure and 23 (17%) cases in private homes. Medical doctors and nurses were the most frequent abortion providers in both urban (84.7%) as well as rural setting (77.2%). The three main reasons for induced abortion were to pursue their studies (34.3%), not yet married (22.6%) and fear of parents (13.9%). Complications were reported by 20% (27/134) of respondents who had carried out voluntary induced abortion. Excessive bleeding was the most reported complication (70.4%). Conclusion: Despite its illegality in Cameroon, the prevalence of voluntary induced abortion was high in this study.
Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing Norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised Not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events.
In countries where abortion remains illegal, its incidence, its influence on fertility, and the circumstances that surround the practice remain unclear and under-researched. The aim of this study is to bring greater clarity and rigour to the above three elements in the Kisii district of Kenya. To do this, an adapted proximate determinants model and a framework based on the influence of the social context on women’s experiences were used. The first provided a quantitative measure of the role of abortion on fertility levels, and the second illuminated the social and personal elements surrounding the practice. The methods used included: the Abortion Incidence Complications Method to estimate the total abortion rate for inclusion into the Proximate Determinants model; interviews; and focus group discussions. The latter two methods stressed social and personal conditions. Other sources of data were recent demographic and health surveys. Findings indicated that the incidence of abortion in the Kisii district was not significant in a technical sense in that its inhibiting effect on fertility was low. However, its practice and social significance indicated a group of women grappling with prevailing religious and official attitudes, inefficiencies in contraceptive provision and the desire to further their education. These findings reinforce the report on the United Nations Fifth Millennium Development Goal which indicates that the maternal health of women in the developing world remains considerably below target.
It is well recognised that unsafe abortions have significant implications for women's physical health; however, women's perceptions and experiences with abortion-related stigma and disclosure about abortion are Not well understood. This paper examines the presence and intensity of abortion stigma in five countries, and seeks to understand how stigma is perceived and experienced by women who terminate an unintended pregnancy and influences her subsequent disclosure behaviours. The paper is based upon focus groups and semi-structured in-depth interviews conducted with women and men in Mexico, Nigeria, Pakistan, Peru and the United States (USA) in 2006. The stigma of abortion was perceived similarly in both legally liberal and restrictive settings although it was more evident in countries where abortion is highly restricted. Personal accounts of experienced stigma were limited, although participants cited numerous social consequences of having an abortion. Abortion-related stigma played an important role in disclosure of individual abortion behaviour.
OBJECTIVE: To determine the proportion of all clinically confirmed pregnancies that end as induced abortion in a cohort of pregnant women in Nigeria. METHODS: A total of 490 women who attended prenatal clinics at the University of Benin Teaching Hospital were interviewed with the preceding birth technique (PBT) on the outcomes of their previous pregnancies, including abortions. RESULTS: Of the 490 women, 384 women (78.4%) reported previous abortions. A total of 1883 previous pregnancies were reported by the women, of which 914 ended in abortion, 545 in live births, and 421 in stillbirths, with 3 unclassified. The total abortion ratio was 914/1842 (49.6%), when 41 women who reported No previous pregnancies were excluded. Of the 914 abortions, 751 (82.25) were induced abortions, 146 (16.0%) were spontaneous abortions, 9 (0.98%) were missed abortions, and 8 were unclassified. Results of logistic regression analysis showed that women aged 25-29 years were 4 times more likely to report induced abortion compared with older women. CONCLUSION: Induced abortion was found to be highly prevalent in this region of Nigeria, according to self-reports of women who were asked questions on abortion in the context of medical care.
The quality of spousal relationship may influence the acceptance of the status of pregnancies and the decision to procure abortion; however, this relationship has largely been unexplored. The objective of this paper is to assess the influence of specific dimensions of relationship quality on abortion procurement. Data from the 2010 Family Health and Wealth Survey site were used to assess the association between relationship quality and induced abortion among 763 ever-pregnant married or cohabiting women in Ipetumodu, South-west Nigeria. Abortion question though not directly related to current time, however, it provides a proxy for the analysis in such context where abortion is highly restrictive with high possibility of underestimation. The association between relationship quality and abortion risk was analyzed using bivariate and multivariate (logistic regression) methods. Only 7.9% of women 15-49 years reported ever having induced abortion. Communication was the only dimension of relationship quality that showed significant association with history of induced abortion (aOR=0.42; 95% C.I. =0.24-0.77). The paper concludes that spousal communication is a significant issue that deserves high consideration in efforts to improve maternal health in Nigeria.
"BACKGROUND: Abortion continues to be used as a method of family planning by many women. The complications of unsafe abortions are a major contributor to maternal mortality in sub-Saharan Africa, including Ghana. This study explored the influence of socio-demographic characteristics on abortions in 156 communities within the Kintampo Health and Demographic Surveillance System (KHDSS) area located in the middle part of Ghana. METHODS:A survey on Sexual and Reproductive Health among a representative sample of females aged 15-49 years was conducted in 2011. They were asked about the outcome of pregnancies that occurred between January 2008 and December 2011. Data on their socio-demographic characteristics including household assets were accessed from the database of the KHDSS. Univariate and multivariate random effects logistic regression models were used to explore the predictors of all reported cases of abortion (induced or spontaneous) and cases of induced abortion respectively. RESULTS:A total of 3554 women were interviewed. Of this total, 2197 women reported on the outcomes of 2723 pregnancies that occurred over the period. The number of all reported cases of abortions (induced and spontaneous) and induced abortions were 370 (13.6%) and 101 (3.7%) respectively. Unmarried women were more likely to have abortion as compared to married women (aOR = 1.77, 95% CI [1.21-2.58], p = 0.003). Women aged 20-29 years were 43% less likely to have abortion in comparison with those within the ages 13-19 years (aOR = 0.57, 95% CI [0.34-0.95], p = 0.030). Women with primary, middle/junior high school (JHS) and at least secondary education had higher odds of having abortion as compared to women without education. Compared with the most poor women, wealthiest women were three-fold likely to have abortion. Unmarried women had higher odds of having induced abortion as compared to married women (aOR = 7.73, 95% CI [2.79-21.44], p < 0.001). Women aged 20-29 years, 30-39 years and 40-49 years were less likely to have induced abortion as compared to those 13-19 years of age. CONCLUSION: Extra efforts are needed to ensure that family planning services, educational programs on abortion and abortion care reach the target groups identified in this study."