Contributing factors to unsafe abortion practices among women of reproductive age at selected district hospitals in the Ashanti region of Ghana

Abstract

Background Despite the existence of an abortion law and a safe abortion policy in Ghana, the Ghana Statistical Service found that 15% of all women in the reproductive age group (15–49 years) have practiced unsafe abortions. The objective of this study was to explore factors that contribute to the high incidence of unsafe abortion practices in the Ashanti Region of Ghana. Methods A qualitative descriptive study design was used to assess factors that contribute to unsafe abortion practices. Purposive sampling technique was employed in selecting participants. Data were collected through key informant interviews and focus group discussions. One hundred and eleven participants were involved in the study. Data analysis was carried out through qualitative content analysis. Results Seven thematic categories were elicited from data collected. The categories are: a) Lack of knowledge of safe abortion services; b) Socio-economic conditions as a perceived influence for unsafe abortion practices; c) Safe abortion as a perceived religious and cultural taboo in Ghana; d) Stigma of unplanned pregnancy; e) A desire to bear children only after marriage; f) Avoiding parental/guardian disappointment and resentment; g) A desire to pursue education. Conclusions Evidence available in this study suggests that several factors are responsible for unsafe abortion practices in Ghana. Lack of knowledge on safe abortion services, poor socio-economic conditions, cultural and religious beliefs, a stigma of unplanned pregnancy, a desire to bear children only after marriage, attempts to avoid parental/guardian disappointment and resentment, and a desire to pursue education were cited by participants as situations that contributed to unsafe abortion practices. Measures such as Aunty Jane, Ms. Rose and Women Help Women programmes can be publicised to reduce maternal morbidity and mortality that occur as a result of unsafe abortions in Ghana. Improvement in family planning education in educational institutions needs to be considered in order to reduce the rate of unwanted pregnancies among young women in school. Electronic supplementary material The online version of this article (10.1186/s12905-019-0759-5) contains supplementary material, which is available to authorized users.

Determinants of Choice of Abortion Methods among Women in Ghana; Does Knowledge on legality of Abortion Matter?

“…This finding is in concordance with findings of other studies. 33 57 It is strongly believed that married women who are in stable unions are likely to receive financial, social and psychological support from their partners and will have easy access to safe abortion services. A study in Nepal found that unmarried women often face different barriers to receiving safe abortion services relative to their married counterparts.…”

“…21-25 Other studies also examine the association between women’s knowledge of abortion law and the practice of induced abortion. 26-29 Further, while some studies use hospital-based data in examining this phenomenon 27 30-32 and community-based surveys 26 28 33 34 , others use nationally representative surveys. 20 25 35 36 These previous studies did not fully explore and examine how demographic, socio-economic factors influence women’s knowledge on the legality of abortion under some conditions (rape, incest, risk to mothers and foetus health) and how that interaction determines their choice of abortion methods.…”

“…Also, some studies argue that in an environment where strict cultural systems, moral and religious laws and conventions prohibits abortion practices, knowledge on legality of abortion can be influenced by several factors at the individual, household, community, societal and national levels. 16 20 22 23 These factors include but not limited to age 43 , marital status 33 , ethnicity 44 , geographical location 45 and economic circumstances. 46 The interaction among these multidimensional factors does influence knowledge on legality of abortion and the decision-making process on the choice of abortion methods.…”

Risk and protective factors for intention of contraception use among women in Ghana

“…Family planning and contraception play an important role in reducing maternal morbidity and mortality by preventing unintended pregnancies (Atakro et al, 2019; Nyarko, 2020). This is in line with the Sustainable Development Goal (SDG) that focuses on ensuring healthy lives and promoting well-being for everybody at all ages (Nyarko, 2020; Pradhan et al, 2017; UNCG SDGs, 2017).…”

Prevalence and Predictors of Contraceptives Use among Women Aged (15–49 years) with Induced Abortion History in Ghana

“…Despite the 1985 Ghanaian law accommodating safe abortion practice on certain medicosocial grounds, there have been observed delays in the formulation and implementation of policies to integrate the law into health services [ 5 ]. Factors such as lack or insufficient knowledge on safe abortion, stigma related to unintended pregnancy, religious beliefs, and implicit nature of the abortion law have significantly influenced safe abortion practice negatively in Ghana [ 5 , 6 ].…”