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BACKGROUND: About 5% to 13% of maternal mortality is directly related to unsafe abortion care. Despite the cultural stigmatization of abortions, Ghana has progressive abortion laws, healthcare guidelines, and clinical outcomes. OBJECTIVE: Our study's primary aim was to characterize abortion outcomes in Ghana. Our secondary aims included investigating factors that led to abortion complications and the treatment of these complications. STUDY DESIGN: We used data from the 2017 Ghana Maternal Health Survey. We examined questions that focused on the reasons for abortion, methods used for abortion, healthcare setting for abortion, and health issues after abortion. We performed descriptive and inferential statistics, including cross tabulation with chi-square analysis and logistic regression models. RESULTS: Between 2012 and 2017, 1,425 women reported and completed the abortion-related questions. For those who obtained an abortion for health reasons, 69% had a surgical-based as opposed to herbal or medication-based abortion (P

AbstractUnsafe abortions contribute significantly to maternal mortality and morbidity in Ghana. To reduce this, in 1982 abortion laws in Ghana underwent reform to broaden the conditions under which abortion is accessed. Although, evidence in other contexts highlights the contribution of violence to women’s experience of unwanted pregnancy and abortion, such evidence is limited within the Ghanaian abortion literature. This study aims to fill that gap. Informed by phenomenology, interviews were conducted with 10 women who had experienced various forms of violence leading to unwanted pregnancy and unsafe abortions. Participants were recruited between June 2017 and March 2018 in the Ashanti region of Ghana where they sought hospital care for unsafe abortion related complications. Participants mentioned intimate partners as the main perpetrators of violence. Financial challenges were also identified as important in increasing women’s vulnerability to violence. Verbal abuse from health workers contributed to denying women access to safe abortion. This paper advances dialogue about the ways in which women’s experience of violence from intimate/non-intimate partners and healthcare workers impacts their overall abortion experience. It advocates the empowerment of women to enable them to leave violent relationships, and the retraining of health workers to enable them to adopt respectful and empathetic care practices. [ABSTRACT FROM AUTHOR]

Background: Unsafe abortions represent a significant public health issue in Cameroon, often resulting in severe health consequences. This study aimed to investigate the prevalence, motivations, and factors associated with unsafe abortions among women in Yaoundé, Cameroon., Methods: A cross-sectional study was conducted among women of childbearing age attending three urban health facilities in Yaoundé, Cameroon. Participants provided information on their reproductive history, including any previous abortions. Data on reasons for abortion, methods used, and sociodemographic factors were collected. Regression analysis was performed to identify factors associated with unsafe abortions., Results: Among 234 women aged 17 to 43, 51 (21.8%) reported at least one unsafe abortion. The primary reasons cited were fear of parental disapproval (24%) and partner refusal (20%). Physicians were the main providers (39.5%), using suction curettage and/or intravaginal misoprostol (89%). Being single (adjusted odds ratio (aOR): 13.6 (5.39-34.4)), nulliparous (aOR: 5.81 (2.41-13.9)), and secondary school students (aOR: 3.23 (1.06-9.81)) were significantly associated with an increased risk of unsafe abortions., Conclusion: Our study highlights the significant public health problem posed by unsafe abortions in Yaoundé, Cameroon. Single, nulliparous women and secondary school students are at heightened risk. These findings emphasize the urgent need for comprehensive sexual and reproductive health education, increased access to contraception, and safe abortion services targeting these groups., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Comité Institutionnel d'Ethique, Université des Montagnes (CIE-UdM) issued approval 2020/062/UdM/PR/CIE. Our study was reviewed and approved by the Institutional Review Board of the Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Fomba Tchoffo et al.)

Background: About 5% to 13% of maternal mortality is directly related to unsafe abortion care. Despite the cultural stigmatization of abortions, Ghana has progressive abortion laws, healthcare guidelines, and clinical outcomes., Objective: Our study's primary aim was to characterize abortion outcomes in Ghana. Our secondary aims included investigating factors that led to abortion complications and the treatment of these complications., Study Design: We used data from the 2017 Ghana Maternal Health Survey. We examined questions that focused on the reasons for abortion, methods used for abortion, healthcare setting for abortion, and health issues after abortion. We performed descriptive and inferential statistics, including cross tabulation with chi-square analysis and logistic regression models., Results: Between 2012 and 2017, 1,425 women reported and completed the abortion-related questions. For those who obtained an abortion for health reasons, 69% had a surgical-based as opposed to herbal or medication-based abortion ( P <.001), 94% had a medical facility-based as opposed to non-medical facility-based abortion ( P <.001), and 21% had health problems related to the abortion within 1 month ( P =.035). Women's reasons for undergoing an abortion did not affect the treatment rates after complications. There was no difference in the occurrence of an abortion-related complication or receipt of treatment for this complication within 1 month after the abortion among those who underwent medical facility-based and those who underwent nonmedical facility based abortion. Those with tertiary-level education or those who knew abortions were legal were more likely to have a surgical and medical facility-based abortion., Conclusion: Although Ghana has room to improve the safety and accessibility of abortion services, our analysis suggests abortions in Ghana, regardless of reason given for seeking the service or method of abortion, seem to be safe. Translating Ghana's approach to abortion could minimize unsafe abortions globally., (© 2024 The Authors.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• The awareness of emergency contraception (EC) among Female Factory Workers (FFWs) is significantly lacking, putting them at risk of unintended pregnancies and unsafe abortions. What is particularly troubling is that a considerable number of FFWs who have experienced unintended pregnancies and unsafe abortions have not utilized Emergency Contraceptive Pills (ECPs) in their lives, potentially due to a lack of awareness and knowledge about these available options. • Despite experiencing unintended pregnancies and/or unsafe abortions, individuals have not obtained the crucial, accurate knowledge, rendering them susceptible to recurring incidents. This situation prompts questions about the effectiveness of current Sexual and Reproductive Health (SRH) programs and the quality of post-abortion counseling within this restricted setting. • The study reveals the urgent need for improved family planning programs that target FFWs, with a focus on increasing knowledge and access to ECP as a means of reducing unintended pregnancy and unsafe abortion. Digital health interventions with innovative ICT tools would be a feasible solution in the factory settings. In Sri Lanka, the Emergency Contraceptive Pill (ECP) is categorized as a Schedule 2A medication, allowing it to be purchased over-the-counter without a prescription, but exclusively from licensed pharmacists. It is estimated that around 3 million ECPs are consumed by Sri Lankan women each year. This study aims to assess the knowledge and practices of Female Factory Workers (FFWs) on ECP and to unearth the association with unintended pregnancy and unsafe abortion. After receiving written informed consent, a structured interview schedule was administered among 585 FFWs attached to eight factories in a selected Export Processing Zone (EPZ). Data analysis was performed using SPSS software. Only 26 % of FFWs were aware of the effective time period to take an ECP to prevent a pregnancy. Most (67 %) had the impression that a valid prescription is required to purchase ECP from the pharmacies. Around one-tenth of the FFWs (11.3 %, n = 66) had used ECP during their lifetime. Among the 65 respondents who reported having experienced unintended pregnancies, only 26.2 % (n = 17) had utilized ECPs. In contrast, among the 22 respondents who disclosed a history of abortion, only two women had ever employed ECPs. The study highlights the low knowledge and use of ECP among FFWs in Sri Lanka, contributing to unintended pregnancy and unsafe abortion. Results call for targeted interventions to improve knowledge and access to ECP, helping to reduce unintended pregnancy and improve reproductive health outcomes. [ABSTRACT FROM AUTHOR]

Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women’s access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women’s access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

Background A case series report based on the Turnaway Study has previously concluded that 99% of women with a history of abortion will continue to affirm satisfaction with their decisions to abort. Those findings have been called into question due to a low participation rate (31%) and reliance on a single yes/no assessment of decision satisfaction. Aim To utilize more sensitive scales in assessing decision satisfaction and the associated mental health outcomes women attribute to their abortions. Method  A retrospective survey was completed by 1,000 females, aged 41-45, living in the United States. The survey instrument included 11 visual analog scales for respondents to rate their personal preferences and outcomes they attributed to their abortion decisions. A categorical question allowed women to identify if their abortions were wanted and consistent with their own values and preferences, inconsistent with their values and preferences, unwanted, or coerced. Linear regression models were tested to identify which of three decision scales best predicted positive or negative emotions, effects on mental health, emotional attachment, personal preferences, moral conflict, and other factors relevant to an assessment of satisfaction with a decision to abort. Results Of 226 women reporting a history of abortion, 33% identified it as wanted, 43% as accepted but inconsistent with their values and preferences, and 24% as unwanted or coerced. Only wanted abortions were associated with positive emotions or mental health gains. All other groups attributed more negative emotions and mental health outcomes to their abortions. Sixty percent reported they would have preferred to give birth if they had received more support from others or had more financial security. Conclusions Perceived pressure to abort is strongly associated with women attributing more negative mental health outcomes to their abortions. The one-third of women for whom abortion is wanted and consistent with their values and preferences are most likely over-represented in studies initiated at abortion clinics. More research is needed to understand better the experience of the two-thirds of women for whom abortion is unwanted, coerced, or otherwise inconsistent with their own values and preferences., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2023, Reardon et al.)

In 2013 the world every day can prevent complications linked to about 800 women have been killed for reasons of pregnancy and birth. The majority of death caused bleeding, hypertension, infections and indirect causes are formed by the interaction between pregnancy with pre-existing health conditions. Developing country, woman's risk of dying from maternity-related causes throughout his life is very higher than women living in a developed country. According to the World Health Organization, the majority of whom are in developed countries (21.2 million) unsafe abortion are performed. Nowadays, especially in developing countries abortions, it continues to be a major problem in women's health and is still the main cause of death among women of reproductive age. Methods of prevention pregnancy and safe abortions are blocked or banned in the countries abortion-related deaths more seen and almost all of these deaths take place in developing countries. The termination of pregnancy in the clinic at the same time, knowledge and skilled, giving advice on the implementation of the method of contraceptive methods by motivated midwives and nurses, increasing the use of method is the most successful model. In our country, these services are healthcare professionals other than specialist (general practitioners, midwives and nurses) in the framework of the law since 1983 is presented by safely and successfully. [ABSTRACT FROM AUTHOR]

Background Women who feel pressured to agree to abortion are more likely to experience negative emotional and mental health reactions. But relatively little research has been conducted to explore the types and degree of pressures women face and their associated effects. Our study aims to investigate five types of pressure women may face and a sample of effects that may be associated with unwanted abortions. Methods A retrospective survey was distributed through a marketing research firm and completed by 1000 females aged 41 to 45, inclusive, living in the United States. The survey instrument included demographic questions and analog scales for respondents to rate the pressure to abort arising from male partners, family members, other persons, financial concerns, and other circumstances and 10 variables related to both positive and negative outcomes. Results Among 226 respondents who reported a history of abortion, perceived pressure to abort was significantly associated with more negative emotions; more disruption of daily life, work, or relationships; more frequent thoughts, dreams, or flashbacks to the abortion; more frequent feelings of loss, grief or sadness about the abortion; more moral and maternal conflict over the abortion decision; a decline in overall mental health that they attribute to their abortions; more desire or need for help to cope with negative feelings about the abortion. Overall, 61% reported high levels of pressure on at least one scale. Women with a history of abortion were four times more likely to quit the survey than women who did not have abortions, and those with a history of feeling pressured to abort also reported higher levels of stress related to completing the survey. Discussion Perceived pressures to choose abortion should be assessed before an abortion to better guide risk assessments, decision-making, and analyses of post-abortion adjustments in light of these risk factors. A history of abortion, especially when there was pressure to abort, is associated with more stress completing questionnaires touching on abortion experiences and with a higher dropout rate, a finding that is consistent with the view that abortion surveys are likely to underrepresent the experiences of the women who experience the most stress and negative reactions to their abortions. Abortion providers should screen for perceived pressures to abort and be prepared to offer counseling and services that will help women to avoid unwanted abortions., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2023, Reardon et al.)

The purposes of this descriptive study of 402 women from southern Thailand, who had undergone a recent abortion (spontaneous, therapeutic and unsafe), were to obtain data regarding their: pregnancy history; number of abortions and cost of abortion related treatments; abortion complications, impacts and related health care services; reasons for having an unsafe abortion; and, circumstances related to an unsafe abortion. Data were collected via use of a structured questionnaire and analyzed using descriptive statistics. Even though 64.3% (n = 259) of the women had either a spontaneous (n = 238) or therapeutic (n = 21) abortion, 35.7% (n = 143) of them had undergone an unsafe abortion. They reported having an unsafe abortion due to: a social problem (not ready for a baby = 60.8%; being unmarried = 24.5%; or, being a student = 23.1%); a financial problem (insufficient income = 42.7%); a family problem (fear of family members being embarrassed = 16.8%; and/or, having enough children 6.1%). They complained, post-abortion, of having experienced: abdominal pain (n = 64; 44.8%); fever (n = 55; 38.5%); anemia (n = 25; 17.5%); and, shock (n = 10; 7.0%). Over one-third (n = 53; 37.1%) of them experienced psychological problems that did not include social or economic issues. Most (n = 115; 80.4%) of those who had an unsafe abortion reported making their own decisions regarding termination of the pregnancy, with 49% (n = 70) indicating they performed their own abortion. Since the majority of women who had experienced an unsafe abortion were confronted with physical, psychological and economical problems, it behooves health care providers to offer counseling services and programs regarding the termination of an unwanted pregnancy. Such services and programs could help pregnant women make informed decisions regarding their health and quality of life. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Reproductive health programs should adopt an approach based on human rights at the levels of clinical management as well as national policy, especially those programs responsible for abortion and post-abortion care. Resource-poor women face greater maternal mortality and morbidity, suffer continuous risk because of a lack of access to adequate reproductive health services, and are likelier than more affluent women to resort to unsafe, inaccessible, and/or unaffordable abortion services. The public health and medical communities are highly effective when providing safe abortion procedures and treatment in the event of complications. Efforts must be continued to develop strategies to prevent unwanted pregnancies, unsafe abortions, and abortion-related deaths; to treat abortion complications; to broaden the types of medical and health professionals who are allowed to perform abortions; and to enhance training for abortion providers. [Copyright &y& Elsevier]

Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7-12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health., Competing Interests: Authors declare no conflict of interest.

Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances., Objective: The aim of the study was to understand midwives' readiness to be involved in legal induced abortions, should the law become less restricted in Ghana., Methods: A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis., Results: Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana's abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women., Conclusion: The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy., Competing Interests: The authors declare no conflicts of interest.

Every year, worldwide, about 42 million women with unintended pregnancies choose abortion, and nearly half of these procedures, 20 million, are unsafe. Some 68,000 women die of unsafe abortion annually, making it one of the leading causes of maternal mortality (13%). Of the women who survive unsafe abortion, 5 million will suffer long-term health complications. Unsafe abortion is thus a pressing issue. Both of the primary methods for preventing unsafe abortion-less restrictive abortion laws and greater contraceptive use-face social, religious, and political obstacles, particularly in developing nations, where most unsafe abortions (97%) occur. Even where these obstacles are overcome, women and health care providers need to be educated about contraception and the availability of legal and safe abortion, and women need better access to safe abortion and postabortion services. Otherwise, desperate women, facing the financial burdens and social stigma of unintended pregnancy and believing they have no other option, will continue to risk their lives by undergoing unsafe abortions.

Approximately 529,000 women die from pregnancy-related causes annually and almost all (99%) of these maternal deaths occur in developing nations. One of the United Nations' Millennium Development Goals is to reduce the maternal mortality rate by 75% by 2015. Causes of maternal mortality include postpartum hemorrhage, eclampsia, obstructed labor, and sepsis. Many developing nations lack adequate health care and family planning, and pregnant women have minimal access to skilled labor and emergency care. Basic emergency obstetric interventions, such as antibiotics, oxytocics, anticonvulsants, manual removal of placenta, and instrumented vaginal delivery, are vital to improve the chance of survival.