Characteristics of women presenting with abortion at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

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To accelerate progress towards achieving the Millenium Development Goal 5 there must be a substantial reduction in abortions, particularly self-induced abortions alongside increased contraceptive uptake. This study describes the characteristics of women presenting with abortion at KATH in Kumasi, Ghana. A better understanding of the relationship between abortion particularly, induced abortion and women's background characteristics can improve our ability to identify subgroups in a population who are in the greatest need of effective contraceptive and post-abortion care services. Such information is valuable to program planners and policymakers in their efforts to facilitate women's ability to plan pregnancies. Systematic random sampling was used to select 420 participants aged 15-49 years presenting with abortion at KATH in a cross-sectional study. The data collected at two points: using a questionnaire from June to August, 2011 while on admission and a telephone conversation (follow-up interview from September to November, 2011) after discharge from KATH were analysed with SPSS version 16 using logistic regression. Majority, 252 (60%) of women who had self-induced abortion were younger than 30, single, unemployed with low education and of low socio-economic status as compared with those with spontaneous abortion who were 30 years or with at least three children, married and had high socio-economic status. It was revealed that, 253 (60.2%) of the respondents did not plan for the index pregnancy and about 64.9% terminated the pregnancy in pursuit of a career and for economic reasons. Also, 280(66.7%) did not use any modern contraceptive prior to the index pregnancy. Reasons gathered from the respondents showed that the fear of side effects contributed to a high rate of 55% post-abortion contraceptive non-use. Of the 420 respondents, only 58 (13.8%) used contraceptives: three months after their discharge from the hospital even though they had been counselled on contraceptive use and had wanted to prevent unintended pregnancies, postpone or delay childbearing. Out of these 58 respondents, 54(93.1%) presented with induced abortion while 4(6.9%) had spontaneous abortion. The study recommemded the sensitisation of all women of reproductive age particularly the youth to use post-abortion contraceptives to help prevent unplanned pregnancies, repeat abortions and maternal mortality. Also, they are to secure safe abortion services in a medical hospital or seek procedure for terminating an unintended pregnancy either by individuals with the necessary skills or in an environment that conforms to minimum medical standards, or both.
A thesis submitted to the Department Of Community Health in partial fulfilment of the requirements for the degree of Master of Public Health (MPH) In Health Services Planning and Management, August - 2012
Self-induced, Spontaneous, Abortion, Post-abortion, Contraceptive use