The relationship between sociodemographic factors and reporting having terminated a pregnancy among Ghanaian women: a population-based study

Abstract

Women who are employed, cohabit with a partner and are considered middle class or wealthy are more likely than their counterparts to report having terminated a pregnancy. Ghanaian women with intermediate levels of education are more likely than both their more- and less-educated counterparts to report having terminated a pregnancy. These findings highlight the need for the development of policies aimed at reducing unsafe abortions associated with unintended pregnancies. Specific recommendations include providing family planning education and outreach to high-risk groups to reduce unintended pregnancies and improving working conditions for expectant mothers, including provisions for paid maternity leave and job protection.

Bayesian spatial analysis of socio-demographic factors influencing pregnancy termination and its residual geographic variation among ever-married women of reproductive age in Bangladesh

“…On the other hand, another study reported that the probability of having terminated pregnancy was higher for women in high socio-economic status [35]. Our study showed that the risk of terminated pregnancies increased with the increased wealth index, which is consistent with the existing literature among Nigerian women based on Nigerian DHS data [49] and Ghanaian women based on Ghana DHS data [18]. Since induced abortion is still illegal in Bangladesh except under certain circumstances, accessing induced abortion or menstrual regulation may be unaffordable for women in low economic status [50].…”

“…The results from our study suggested that women who were involved in any occupation were at an increased risk of reported pregnancy termination in Bangladesh. This is consistent with another study conducted by in Ghanaian women based on Ghana DHS data [18]. There might be several reasons for employed women to experience terminated pregnancies compared to non-working women: decision-making power of working women regarding their reproductive health, prioritizing career goals over pregnancy, being more aware of contraceptive options including, menstrual regulation [18], or access to induced abortion through financial means [43] even though abortion is still illegal in Bangladesh.…”

“…Since induced abortion is still illegal in Bangladesh except under certain circumstances, accessing induced abortion or menstrual regulation may be unaffordable for women in low economic status [50]. Such a trend in pregnancy termination in terms of wealth index may be also explained by the increased financial power of women in higher socio-economic class [18].…”

“…Previous investigations on pregnancy termination are mostly based on logistic regression without accounting for geographical clustering [18,38]. If the residuals of the regression model are independent and not spatial correlated, the model can be fitted using the frequentist survey logistic regression or generalized additive mixed effect models.…”

“…Previous studies have identified socio-demographic factors that are associated with pregnancy termination in developing countries. For example, age of the women at the survey time, marital status, education level, employment status and total number of children have were reported to be significantly associated with an increased risk of pregnancy termination [14][15][16][17][18][19][20][21][22]; however, the research findings in terms of the direction and the strength of the associations have been mixed. In the context of Bangladesh, only a few studies examined the risk factors associated with pregnancy terminations at some specific regions [23][24][25], which found older women with lower education are at an increased risk of having pregnancy termination.…”