A longitudinal study on different models of postabortion care in Tanzania

Rasch, Vibeke; Massawe, Siriel; Mchomvu, Yasinta; Mkamba, Mashombo; Bergström, Staffan

doi:10.1111/j.0001-6349.2004.0529.x

Cited by 15 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More than two-third of the women who were admitted with an incomplete abortion reported having had an unsafely induced abortion prior to admittance in the hospital. Similarly high rates of unsafe abortions have been reported in other Tanzanian studies [ 9 , 12 , 13 ]. Almost half of the women had either turned to traditional providers to have a clandestine abortion or self-induced their abortion.…”

Section: Discussionsupporting

confidence: 82%

Unsafe abortion in rural Tanzania – the use of traditional medicine from a patient and a provider perspective

Rasch

Sørensen

Wang

et al. 2014

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

BackgroundThe circumstances under which women obtain unsafe abortion vary and depend on the traditional methods known and the type of providers present. In rural Tanzania women often resort to traditional providers who use plant species as abortion remedies. Little is known about how these plants are used and their potential effect.MethodsData were obtained among women admitted with incomplete abortion at Kagera Regional Hospital during the period January - June, 2006. The women underwent an empathetic interview to determine if they had experienced an unsafe abortion prior to their admission. In all 125/187 women revealed having had an unsafe abortion. The women identified as having had an unsafe abortion underwent a questionnaire interview where information about abortion provider and abortion method used was obtained through open-ended questions. To get more detailed information about the traditional methods used to induce abortion, in-depths interviews and focus group discussions were performed among traditional providers and nurses. Finally, the plant specimen’s effectiveness as abortion remedies was assessed through pharmacological analyses.ResultsAmong women admitted with incomplete abortions, 67% had had an unsafe abortion. Almost half of the women who had experienced an unsafe abortion had resorted to traditional providers and plant species were in these cases often used as abortion remedies. In all 21 plant species were identified as potential abortion remedies and analysed, 16 of the species were found to have a uterine contractive effect; they significantly increased the force of contraction, increased the frequency of contractions or did both.ConclusionUnsafe abortion is common in rural Tanzania where many women use plant species to terminate an unwanted pregnancy. The plants have a remarkable strong uterine contractive effect. To further understand the consequences of unsafe abortion there is a need for further analyses of the plants’ potential toxicity and mutagenicity.

show abstract

Section: Discussionsupporting

confidence: 82%

Unsafe abortion in rural Tanzania – the use of traditional medicine from a patient and a provider perspective

Rasch

Sørensen

Wang

et al. 2014

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

show abstract

“…In two hospital-based studies from Tanzania 52 % to 63 %, respectively of women with abortion complications admitted to have had an unsafe abortion, when interviewed with an empathetic approach [ 30 , 31 ]. This large number of women undergoing unsafe abortion contrasts our study.…”

Section: Discussionmentioning

confidence: 99%

Management of abortion complications at a rural hospital in Uganda: a quality assessment by a partially completed criterion-based audit

et al. 2015

View full text Add to dashboard Cite

BackgroundComplications of unsafe abortion are a major contributor to maternal deaths in developing countries. This study aimed to evaluate the clinical assessment for life-threatening complications and the following management in women admitted with complications from abortions at a rural hospital in Uganda.MethodsA partially completed criterion-based audit was conducted comparing actual to optimal care. The audit criteria cover initial clinical assessment of vital signs and management of common severe complications such as sepsis and haemorrhage. Sepsis shall be managed by immediate evacuation of the uterus and antibiotics in relation to and after surgical management. Shock by aggressive rehydration followed by evacuation.In total 238 women admitted between January 2007 and April 2012 were included. Complications were categorized as incomplete, threatened, inevitable, missed or septic abortion and by trimester. Actual management was compared to the audit criteria and presented by descriptive statistics.ResultsFifty six per cent of the women were in second trimester. Abortion complications were distributed as follows: 53 % incomplete abortions, 28 % threatened abortions, 12 % inevitable abortions, 4 % missed abortions and 3 % septic abortions. Only one of 238 cases met all criteria of optimal clinical assessment and management. Thus, vital signs were measured in 3 %, antibiotic criteria was met in 59 % of the cases, intravenous fluid resuscitation was administered to 35 % of women with hypotension and pain was managed in 87 % of the cases. Sharp curettage was used in 69 % of those surgically evacuated and manual vacuum aspiration in 14 %. In total 3 % of the abortions were categorized as unsafe. Two of eight women with septic abortion had evacuation performed during admission-day, one woman died due to septic abortion and one from severe haemorrhage.ConclusionsGuidelines were not followed and suboptimal assessment or management was observed in all but one case. This was especially due to missing documentation of vital signs necessary to diagnose life-threatening complications, poor fluid resuscitation at signs of shock, and delayed evacuation of septic abortion.

show abstract

“…The women were counselled in detail about contraception and how to avoid becoming infected with HIV and thereafter offered ward-based contraceptive service. Follow-up data were obtained 12 months after the women had had the abortion by a combination of hospital-based and home-based interviews [ 17 ]. In relation to the 12 months' interviews detailed information about the women's present contraceptive use, their possible motives for not using contraception, and pregnancies experienced during the observation period was obtained.…”

Section: Methodsmentioning

confidence: 99%

Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania

Rasch

Yambesi

Massawe

2008

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

BackgroundPostabortion contraceptive service is considered an effective means in addressing the problem of unsafe abortion; in spite this fact this component remains one of the weakest parts of postabortion care. In this context, the paper aims to describe the impact of a postabortion contraceptive service intervention among women admitted with complications from unsafe abortions and to explore the women's long-term contraceptive adherence.Methods392 women having experienced unsafe abortion were identified by an empathetic approach and offered postabortion contraceptive service, which included counselling on HIV and condom use. Questionnaire interviews about contraceptive use were conducted at the time of inclusion and 12 months after the abortion. Additionally, in-depth interviews were performed 6–12 months after the abortion.ResultsEighty-nine percent of the women accepted postabortion contraception. Follow-up information was obtained 12 months after the abortion among 59 percent of the women. Among these, 79 percent of the married women and 84 percent of the single women stated they were using contraception at 12 months. Condom use among the single women increased significantly during the 12 months follow up.ConclusionPostabortion contraceptive services appear to be well accepted by women who are admitted with complications after an unsafe abortion and should thus be recognized as an important means in addressing the problem of unsafe abortion. In addition, counselling about HIV and condom use should be considered an essential aspect of postabortion care.

show abstract

A longitudinal study on different models of postabortion care in Tanzania

Abstract: If hospital-based and confidential home-based interviews are used combined and if the women having unsafe abortions are counseled by technically well-skilled counselors, it is possible to achieve a reasonable follow-up rate among women having unsafe abortions.

Cited by 15 publications

References 9 publications

Unsafe abortion in rural Tanzania – the use of traditional medicine from a patient and a provider perspective

Unsafe abortion in rural Tanzania – the use of traditional medicine from a patient and a provider perspective

Management of abortion complications at a rural hospital in Uganda: a quality assessment by a partially completed criterion-based audit

Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania

Contact Info

Product

Resources

About