Attitude of Women with Abortion-Related Complications toward Provision of Safe Abortion Services in Ghana

Konney, Thomas Okpoti; Danso, Kwabena A.; Odoi, Alexander T.; Opare‐Addo, Henry S.; Morhe, Emmanuel

doi:10.1089/jwh.2008.1190

Cited by 22 publications

(37 citation statements)

References 8 publications

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“…About 60% of abortions in this study were induced with misoprostol, confirming earlier reports that misoprostol had become a popular and relatively cheap over the counter abortifacient among women in Kumasi [11], and possibly in Ghana. The figure is however, lower than 83% reported earlier in the same centre [11], but much higher than the 5-16% reported in the 2007 Ghana Maternal Health Survey [8].…”

Section: Resultssupporting

confidence: 89%

“…Consistent with characteristics of induced-abortion clients in Ghana [8,9,11,20,21] and other countries [15,22], we found that misoprostol users were younger, not married, nulliparous, and had better educational background than non-users. Gestational age at which pregnancy was terminated and being nulliparous were independent risk factors for severe morbidity following termination of pregnancy.…”

Section: Resultssupporting

confidence: 85%

“…In Ghana, induced abortion complications account for 11% of maternal mortality nationwide [8], and up to 12% of gynaecological admissions in leading public tertiary hospitals [10,11]. These voluntary terminations of pregnancy are more common in urban areas and among younger women [5,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Different methods are used for these terminations. Recent evidence from one study, indicated that over 80% of the women self-induced abortions with misoprostol [11]. Misoprostol is a prostaglandin E 1 analogue that is licensed for the treatment of peptic ulcer disease.…”

Section: Introductionmentioning

confidence: 99%

“…With increasing popularity of misoprostol as an over the counter self-administered abortifacient in Ghana [11], it is imperative that the morbidities associated with its use are investigated. While most studies on induced abortions have compared complications of spontaneous and induced abortions, there is paucity of research on morbidities associated with misoprostol-induced abortions.…”

Section: Introductionmentioning

confidence: 99%

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Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana

et al. 2014

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BackgroundMisoprostol has become a popular over the counter self-administered abortifacient in Ghana. This study aimed to compare the socio-demographic characteristics and clinical complications associated with misoprostol and non-misoprostol induced abortions among patients admitted to a tertiary public health facility in Ghana.MethodsThis was a cross sectional study conducted at the gynaecological ward of Komfo Anokye Teaching Hospital (KATH), over a four-month period using a structured pre-tested questionnaire. Data were analysed using Chi-square, Fisher’s exact and student t-tests. Factors associated with severe morbidity were examined using Poisson regression with robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant.ResultsOverall, 126 misoprostol users and 126 misoprostol non-users were recruited into the study. About 71% of the clients had self-induced abortions. Misoprostol users were more likely to be younger (p < 0.001), single (p < 0.001), nulliparous (p = 0.001), of higher educational background (p = 0.001), and unemployed (p < 0.001), than misoprostol non-users. Misoprostol users were more likely than non-users to undergo termination of pregnancy because they wanted to continue schooling (p < 0.001) or were not earning regular income to support a family (p = 0.001). Overall, 182 (72.2%) of the women (79.4% misoprostol users vs. 65.1% misoprostol non-users; p = 0.01) suffered severe morbidity. Nulliparous women (adjusted RR, 1.28; 95% CI, 1.08-1.52) and those who had induced abortion after 12 weeks’ gestation (adjusted RR, 1.36; 95% CI, 1.18-1.57) were at increased risks of experiencing severe morbidity. The association between mode of abortion induction and severe morbidity was not statistically significant (p = 0.06).ConclusionSelf-induced abortions using misoprostol is a common practice among women in this study; nearly three quarters of them suffered severe morbidity. Nonetheless, severe morbidity among misoprostol users and non-users did not differ significantly but was directly related to the gestational age at which the induced abortions occurred. Health education on the dangers of self-induced abortions and appropriate use of medication abortion could help reduce complications associated with induced abortions in Ghana.

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Section: Resultssupporting

confidence: 89%

Section: Resultssupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana

et al. 2014

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Determining the accuracy of pregnancy‐length dating among women presenting for induced abortions in Ghana

Shellenberg¹,

Antobam²,

Griffin³

et al. 2017

Intl J Gynecology & Obste

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Objective: To determine the proportion of women presenting for an induced abortion in Ghana who could use a gestational wheel to determine if they had reached at least 13 weeks or fewer than 13 weeks of pregnancy accurately. Methods:The present cross-sectional study was conducted at four facilities in Ghana between February 1, and July 31, 2014. Women aged at least 18 years seeking induced abortions who had not previously been informed of the length of their pregnancy by a clinician were enrolled. Women self-assessed pregnancy duration using a gestational wheel before a clinician assessed the length via clinical assessment and bimanual exam for use as a respective reference point. The proportion of participants who used the wheel successfully was calculated. Results:The study enrolled 780 participants, 770 of whom used the gestational wheel.Of these, 221 (28.7%) could use the wheel without verbal instructions, and 465 (60.4%) described it as easy to use. Agreement in pregnancy-length assessments was recorded for 728 (94.5%) patients. There were 10 (1.3%) and 28 (3.6%) participants who made evaluations with "low-risk disagreement" and "high-risk disagreement" with the clinician assessment, respectively. Conclusion:Almost all participants could use the gestational wheel to date their pregnancies correctly. This tool could help women perform medical abortions safely in the community, reducing morbidity and mortality from unsafe abortions. K E Y W O R D SAbortion; Gestational dating; Ghana; Medical abortion; Misoprostol; Reproductive health | INTRODUCTIONDespite Ghana having relatively liberal laws surrounding induced abortion, evidence has demonstrated that the self-administration of misoprostol by women outside clinical settings is common practice. [1][2][3] Misoprostol alone, when administered according to the regimen recommended by WHO, is an effective medical abortion technique with a success rate of 85% for patients at up to 9 weeks of pregnancy. 4 Although there is limited evidence of the effectiveness of misoprostol for induced abortion of pregnancies at 9-13 weeks, WHO has endorsed using the evidence-based regimen for earlier than 9 weeks of pregnancy for pregnancies between 9 and 13 weeks. 5 Given the safety and simple administration of the regimen, arguments have been made against the need for clinical oversight in the use of misoprostol,This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana

Rominski

Bell

Yawson

et al. 2019

Intl J Gynecology & Obste

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Objective In this study, we sought to determine to what extent the abortion law in Ghana is reflective of public opinion. Methods In a cross‐sectional, community‐based survey, individuals in two fishing communities in Accra were interviewed about their beliefs on abortion between May and July 2016, and sociodemographic, attitudinal, and experience data were collected. Factors associated with the outcome variable (abortion is justified to save the life/health of the woman: Yes/No) were entered into a multivariate logistic regression. Results A total of 508 participants completed the survey. Thirty‐nine percent (n=198) of the sample agreed that abortion was justified to save the life/health of the woman, with no significant differences in this finding when controlling for understanding of the law, gender, marital status, or personal experience of abortion in multivariate analysis. Higher education (odds ratio [OR] 1.64 [P<0.001]) and older age (OR 1.28 [P<0.001]) are positively associated with abortion being justified to save life/health, while those who have had an experience of unwanted sex are less likely to believe that (OR 0.60 [P=0.029]). Conclusion The participants held conservative views about the justification of abortion to save a woman's life and/or health. Improving access to safe abortion services will require acknowledgment of the broader social and cultural context that may make accessing such services difficult.

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Attitude of Women with Abortion-Related Complications toward Provision of Safe Abortion Services in Ghana

Abstract: Awareness of the current legal status of abortion was lacking among women with abortion-related complications attending a tertiary center in Kumasi. However, the provision of safe abortion services was much needed in this population.

Cited by 22 publications

References 8 publications

Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana

Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana

Determining the accuracy of pregnancy‐length dating among women presenting for induced abortions in Ghana

Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana

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