Prognostic factors of time to first abortion after sexual debut among fragile state Congolese women: a survival analysis

Abstract

Background Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to investigate the prevalence of abortion, the reasons women had abortions, median years to first abortion after sexual debut and examine the factors of time to first abortion among women of reproductive age in the Republic of Congo. Methods We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3622 women aged 15–49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p < 0.05. Results The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34, 67, 86 and 94% higher risk of abortion respectively, when compared with women from poorest households (all p < 0.05). Women currently in union/living with a man and formerly in union had 41 and 29% reduction in the risk of abortion respectively, when compared with those never in union (all p < 0.05). In addition, women with primary and secondary+ education had 42 and 76% higher risk of abortion respectively, when compared with women with no formal education (all p < 0.05). Conclusion There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

When Do Nigerian Women of Reproductive Age Initiate and What Factors Influence Their Contraceptive Use? A Contextual Analysis

“…The median time (years) to contraceptive uptake was used to determine timing of contraceptive initiation using the Kaplan–Meier survival analysis. 33 We conducted multivariable logistic regression to determine the factors associated with contraceptive use. Analyses were conducted using Stata Version 14 (StataCorp 2014).…”

Individual and community-level factors associated with repeat induced abortion among women in Ghana: a multivariable complex sample logistic regression analysis of 2017 Ghana maternal health survey

“…Numerous studies have established a strong association between contraception and induced abortion practices among women [ 37 , 40 , 42 – 44 ] and this study was an exception. Our findings revealed that women using contraceptives at the time of conception were more likely to have engaged in repeat induced abortion relative to those who were not using contraceptive at the time of conception.…”

“…This study found a higher likelihood of repeat induced abortion among women who had attained middle levels of education compared to those with no formal education. While some earlier studies reported contrary results [ 1 , 7 , 36 , 38 ], others found similar findings [ 33 , 37 , 40 ]. Studies that found lower rates of repeated induced abortion among low educated women argued that a low level of education is strongly associated with a lower use of contraceptives, which leads to unintended pregnancies and subsequent abortion [ 33 ].…”