Abortion-related mortality in a tertiary medical centre in Enugu, Nigeria

Nwogu-Ikojo, E. E.; Ezegwui, HU

doi:10.1080/01443610701718883

Cited by 17 publications

(17 citation statements)

References 13 publications

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“…The vast majority of abortion‐related deaths occur in Sub‐Saharan Africa (about 36 000) and south Central Asia (about 28 400), whereas the number is negligible in southern and western Europe, North America and China (3). In Tanzania, a recent review of 113 maternal deaths suggested that 14 (12%) women had died following an unsafe abortion (24), while in Nigeria 12–13% of maternal deaths have been reported to be due to unsafe abortion (25,26). The reported figures from Tanzania and Nigeria are in accordance with the global estimate of unsafe abortion accounting for 13% of all maternal deaths (3).…”

Section: Resultsmentioning

confidence: 99%

Unsafe abortion and postabortion care - an overview

Rasch

2011

Acta Obstetricia Et Gynecologica Scandinavica

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Forty per cent of the world's women are living in countries with restrictive abortion laws, which prohibit abortion or only allow abortion to protect a woman's life or her physical or mental health. In countries where abortion is restricted, women have to resort to clandestine interventions to have an unwanted pregnancy terminated. As a consequence, high rates of unsafe abortion are seen, such as in Sub-Saharan Africa where unsafe abortion occurs at rates of 18-39 per 1 000 women. The circumstances under which women obtain unsafe abortion vary and depend on traditional methods known and types of providers present. Health professionals are prone to use instrumental procedures to induce the abortion, whereas traditional providers often make a brew of herbs to be drunk in one or more doses. In countries with restrictive abortion laws, high rates of maternal death must be expected, and globally an estimated 66 500 women die every year as a result of unsafe abortions. In addition, a far larger number of women experience short- and long-term health consequences. To address the harmful health consequences of unsafe abortion, a postabortion care model has been developed and implemented with success in many countries where women do not have legal access to abortion. Postabortion care focuses on treatment of incomplete abortion and provision of postabortion contraceptive services. To enhance women's access to postabortion care, focus is increasingly being placed on upgrading midlevel providers to provide emergency treatment as well as implementing misoprostol as a treatment strategy for complications after unsafe abortion.

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Section: Resultsmentioning

confidence: 99%

Unsafe abortion and postabortion care - an overview

Rasch

2011

Acta Obstetricia Et Gynecologica Scandinavica

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“…Across the world, students in higher institutions of learning constitute an influential group of young people. Studies from South East Nigeria have shown that the level of sexual activity among young people in tertiary educational institutions is high,2 and that complicated illegally induced abortion for unwanted pregnancy has increased five-fold over the previous decades with significant abortion-related mortality 3,4. In addition, Enugu state has one of the highest rates of human immunodeficiency virus infection among pregnant women in Nigeria 5.…”

Section: Introductionmentioning

confidence: 99%

Peer-driven contraceptive choices and preferences for contraceptive methods among students of tertiary educational institutions in Enugu, Nigeria

Iyoke

Ezugwu

Lawani

et al. 2014

PPA

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PurposeTo describe the methods preferred for contraception, evaluate preferences and adherence to modern contraceptive methods, and determine the factors associated with contraceptive choices among tertiary students in South East Nigeria.MethodsA questionnaire-based cross-sectional study of sexual habits, knowledge of contraceptive methods, and patterns of contraceptive choices among a pooled sample of unmarried students from the three largest tertiary educational institutions in Enugu city, Nigeria was done. Statistical analysis involved descriptive and inferential statistics at the 95% level of confidence.ResultsA total of 313 unmarried students were studied (194 males; 119 females). Their mean age was 22.5±5.1 years. Over 98% of males and 85% of females made their contraceptive choices based on information from peers. Preferences for contraceptive methods among female students were 49.2% for traditional methods of contraception, 28% for modern methods, 10% for nonpharmacological agents, and 8% for off-label drugs. Adherence to modern contraceptives among female students was 35%. Among male students, the preference for the male condom was 45.2% and the adherence to condom use was 21.7%. Multivariate analysis showed that receiving information from health personnel/media/workshops (odds ratio 9.54, 95% confidence interval 3.5–26.3), health science-related course of study (odds ratio 3.5, 95% confidence interval 1.3–9.6), and previous sexual exposure prior to university admission (odds ratio 3.48, 95% confidence interval 1.5–8.0) all increased the likelihood of adherence to modern contraceptive methods.ConclusionAn overwhelming reliance on peers for contraceptive information in the context of poor knowledge of modern methods of contraception among young people could have contributed to the low preferences and adherence to modern contraceptive methods among students in tertiary educational institutions. Programs to reduce risky sexual behavior among these students may need to focus on increasing the content and adequacy of contraceptive information held by people through regular health worker-led, on-campus workshops.

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Induced abortion is legally restricted in Nigeria; it is permitted only to save the life of the woman and, in the southern states of the country, also for physical and men-tal health reasons (Ogiamien 2000). Despite the restrictive abortion law, several reports (Okonofua et al 1999;Nwogu-Ikojo and Ezegwui 2007;Bankole et al 2008) indicate that induced abortion is widespread in the country and that it is associated with high rates of maternal morbidity and mortality. Data from the Federal Ministry of Health suggest that complications of induced abortion account for an estimated 20 percent of maternal deaths in Nigeria.

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confidence: 99%

“…A study of women in two states of Nigeria (Okonofua et al 1999) revealed that more than 30 percent of the women who indicated that their abortions were performed by private medical providers mentioned that they had experienced significant complications following the abortion procedure. Similarly, audits of complications and deaths associated with unsafe abortion in various parts of the country indicate that most abortion procedures that resulted in severe complications and hospitalizations were carried out by private medical providers (Nwogu-Ikojo and Ezegwui 2007). Our previous study of private medical practitioners, which drew upon 2001 data and did not include questions on medical abortion, revealed that although up to 40 percent reported that they operate a policy of terminating unwanted pregnancies in their clinics, many did not employ current evidence-based procedures for doing so .…”

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Private Medical Providers' Knowledge and Practices Concerning Medical Abortion in Nigeria

Okonofua¹,

Hammed

Abass

et al. 2011

Studies in Family Planning

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To investigate the knowledge and practices regarding medical abortion and postabortion care in northern Nigeria among private physicians--the principal providers of such services in the area--122 doctors operating separate clinics in five states--Bauchi, Borno, Kaduna, Niger, and Taraba--were interviewed by means of a structured questionnaire. The results showed that 22 percent of the doctors reported that they terminate unwanted pregnancies, whereas nearly all reported that they manage complications of unsafe abortion. Manual vacuum aspiration and dilatation and curettage performed singly or in combination were the most common methods of abortion and postabortion care reported by the doctors. Only one doctor reported exclusive use of medical abortion in the first trimester, and three reported its exclusive use in the second trimester. Only 35 percent of the doctors listed misoprostol as a drug that they knew could be used for abortion and postabortion care, and only 12 percent listed mifepristone. By contrast, 49 percent listed inappropriate or dangerous drugs for use in abortion provision in the first and second trimesters of pregnancy. We conclude that private practitioners in northern Nigeria have limited knowledge of medical abortion and postabortion care, and that a capacity-building program on the subject should be instituted for them.

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Abortion-related mortality in a tertiary medical centre in Enugu, Nigeria

Cited by 17 publications

References 13 publications

Unsafe abortion and postabortion care - an overview

Unsafe abortion and postabortion care - an overview

Peer-driven contraceptive choices and preferences for contraceptive methods among students of tertiary educational institutions in Enugu, Nigeria

Private Medical Providers' Knowledge and Practices Concerning Medical Abortion in Nigeria

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