Determinants of induced abortion among women received maternal health care services in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case–control study

Abstract

Background About 210 million women become pregnant per year, with one out of every ten pregnancies terminating unsafely worldwide. In developing countries, unsafe induced abortion is a leading cause of maternal mortality and morbidity. In addition, the burden of public health is also greatest in developing regions. In Ethiopia, abortion was responsible for 8.6% of maternal deaths. Despite the problem's significance, little is known about the factors that lead to women terminating their pregnancies. Therefore, this study aims to identify the factors associated with having induced abortion in public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. Methods An institutional-based unmatched case–control study was conducted among 413 women from 15th April to 15th June 2021 in selected public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. Cases were women who received induced abortion care services or who received post-abortion care services after being presented to the selected public hospital with an attempt of induced abortion whereas controls were women who came for maternal health care (antenatal or postnatal care) services in selected public hospitals and never had history of induced abortion. The data were collected by pretested and structured questionnaires with face-to-face interviews via Kobo Collect v3.1 mobile tools and analyzed by STATA version14. Logistic regression model was used to identify factors associated with induced abortion. In this study P-value less than 0.05 with 95% CI was declared a result as statistically significant. Results In this study, 103 cases and 309 controls were participated. Urban residence (AOR = 2.33, 95%CI:1.26, 4.32), encountered first sex at age of 20–24 years (AOR = 0.51, 95%CI:0.27,0.97), multiple sexual partner (AOR = 5.47, 95%CI: 2.98,10.03), women who had one child (AOR = 0.32, 95%CI: 0.10, 0.99), and good knowledge of contraceptives (AOR = 0.12, 95%CI: 0.03, 0.46) were identified as determinants of induced abortion. Conclusions Interventions focusing on those identified factors could probably reduce the burden and consequences of induced abortion. Sexual and reproductive health education and family planning programs would target urban dwellers, women who start sexual intercourse between the ages of 15 and 19, women with more than one sexual partner, women with a desire to limit childbearing, and women with poor contraceptive knowledge in order to reduce induced abortion.

Prevalence and determinants of pregnancy termination in Ethiopia: a systematic review and meta-analysis

“…This review included 33 studies conducted in various regions of Ethiopia. Of all the studies, 8 (24.24%) were from the Amhara Region,11 12 15 16 23–26 South Nations and Nationalities Peoples accounted for 9 (27.27%) of the total,13 27–34 1 was from Oromia,35 5 (15.15%) from Addis Ababa city administration,10 14 36–38 3 (9.09%) were from Harari region,39–41 3 (9.09%) were from Tigray region,42–44 1 (3.03%) was from Afar region and45 3 (9.09) were from National data 46–48. 28 (84.85%) of the included articles were cross-sectional studies,10–13 15 23–31 33–35 37–42 44–48 and remains 5 (15.15%) were case–control studies 14 16 32 36 43…”

“…As well, 27 of the studies were institution based,10–16 24 27–33 35–46 while 6 were community-based studies 23 25 26 34 47 48. The sample size of the included studies ranged from a minimum of 124 in a study conducted in southwest Ethiopia34 and to a maximum of 12 378 in a study conducted using Demographic Health Survay (DHS) data 48.…”

Multilevel analysis of factors associated with pregnancy termination in Ethiopia

“…From this study, Women living in Addis Ababa (13.20%) had terminated pregnancy greater rate than any other Region and Administrative City while women living in Tigray (2.73%) had terminated pregnancy lower rate than any other Region and Administrative City. The Ethiopian Demographic and Health Survey study found that women of reproductive age in Addis Ababa had the smallest optimum family size (3.6 children) and the lowest fertility rate (1.8) in the country [ 30 , 31 ]. Women in Addis Ababa who want to have a small family might have their pregnancies terminated to space birth intervals or limit births.…”

“…Ethiopia is one of Sub-Saharan Africa's low-income countries with the highest maternal morbidity and death rates. According to the 2016 Ethiopia Demographic and Health Survey, the maternal mortality rate in Ethiopia was 412 deaths per 100,000 live births (2016 EDHS) [ 8 , 9 ].…”

Uso de métodos anticonceptivos de alta eficacia posterior a la interrupción voluntaria del embarazo en Profamilia, 2015-2020

“…Después del aborto inducido, la ovulación puede reanudarse en los primeros diez días tras la intervención [6]. En los casos en que la mujer ha tenido un aborto, la educación en métodos anticonceptivos aumenta la consciencia acerca de su fecundidad, reduce la incidencia de gestaciones no planeadas y, por lo tanto, de interrupciones del embarazo [7,8]. Es por esto por lo que es de suma importancia hacer una adecuada asesoría en métodos anticonceptivos, en la cual se pueda proporcionar, a la paciente, el mejor método anticonceptivo, teniendo en cuenta los criterios de elegibilidad de la oms y la preferencia de la mujer.…”