Self-managed Abortion as a Medico-legal Intervention in Ghana: a Systematic Review

Abstract

BackgroundWe examined the potential of improving self-managed abortion as a medico-legal intervention of safely and effectively resolving unwanted pregnancies in Ghana.MethodsWe undertook a systematic literature review on self-managed or self-induced abortion within the context of Ghanaian laws. We searched for studies from Advanced PubMed Central and Google Scholar and repositories of Public Universities in Ghana. With search words of self-managed or self-induced abortion and Ghanaian law, we found 13,100 papers. The search was then narrowed to studies conducted between 2015-2020 of which 22 most related papers were selected with Six (6) from the Advanced Google Scholar search, 18 from PubMed and 1 unpublished postgraduate thesis from a public university library.ResultsDespite a liberal law that supported positive and quite well-decentralized service delivery policy, standards, and protocols development on abortion in Ghana, self-induced abortion remains criminalized. Nonetheless, the longstanding practice persists with no evidence of prosecution of the person(s) found violating the law within the period under review. The use of abortifacients procured from pharmacies and chemists that are not recognized abortion care providers has become the leading method of self-induced. Conclusion Despite criminalizing self-induced abortion, Ghana’s law on abortion is fairly liberal enough to permit the development of comprehensive abortion care policy, standards, and protocols that have a good potential of supporting improved self-managed abortion to reduce maternal morbidity and mortality in the country. Further studies are required for the exploration of ways of filling implementation gaps to harness the potentials of improving self-managed abortions in Ghana.