scholarly journals An Overview of Comprehensive Abortion Care at Tertiary care Teaching Hospital

2019 ◽  
Vol 2 (1) ◽  
pp. 149-154
Author(s):  
Sunita Bhandari ◽  
Yam Dwa ◽  
Smrity Maskey ◽  
Manisha Bajracharya ◽  
Minaxi Thakur
Keyword(s):  
Mental Health ◽  
Teaching Hospital ◽  
Maternal Mental Health ◽  
Care Service ◽  
First Trimester ◽  
Second Trimester ◽  
Total Study Population ◽  
Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Introduction: With the beginning of comprehensive abortion care service in Nepal, since 2004, safe abortion services in the first trimester are available in all 75 district hospitals of Nepal. Nepal has expanded comprehensive abortion care into the second trimester in 2007. This study tries to investigate the reasons for using comprehensive abortion care service and to know the post-abortion contraceptive acceptance among women presenting at first and second trimester of gestation.Materials and Methods: This hospital-based prospective study was conducted among women seeking comprehensive abortion care service at first and second trimester of gestation in the outpatient department of Obstetrics & Gynaecology, KIST Medical College and Teaching Hospital from July 2017 to July 2018. Data collection was done by filling proforma and was analyzed.Results: There were a total of 171 clients, out of which 78.95% (n=135) were in the first trimester and 21.05% (n=36) in the second trimester of pregnancy. The reason in the first trimester was completed family (39.25%) and the main reason for the second trimester was maternal mental health (48.71%). Among the total study population, 16.37% (n=28) accepted contraception. The most common accepted contraceptive method was implant (n=14; 8.1%), followed by inj. depot medroxyprogesterone acetate (n=8; 4.6%).Conclusions: The prevalence of second-trimester abortion is high despite the availability of first-trimester comprehensive abortion care service. The main reason for induced abortion in first trimester was completed family and in second-trimester was maternal mental health. Post-abortion contraceptive acceptance among comprehensive abortion care clients was very low.

scholarly journals Post Abortion Choice and Acceptance of Contraception

2013 ◽  
Vol 8 (1) ◽  
pp. 14-17
Author(s):  
Ashis Shrestha ◽  
P Sharma
Keyword(s):  
Care Service ◽  
First Trimester ◽  
Contraceptive Device ◽  
Trimester Abortion ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Aims: This study was conducted to find out choice and acceptance of contraceptives in clients coming for first trimester abortion. Methods: This was a cross sectional descriptive study carried out from the records of clients who received comprehensive abortion care service in first trimester at Kasthamandap health care centre from June 2008 to June 2010. Results: Total 707 clients came for abortion who fulfilled inclusion criteria. Contraceptive acceptance was 49.5%. Most frequently used contraceptives were injectable (depot medroxyprogesterone) 22.8%, oral contraceptive pills 19.6%, condom 6.1%, intra-uterine contraceptive device 0.8% and norplant 0.3%. Conclusions: This study showed a low acceptance rate of contraception. This suggests the need for reviewing the policy of post abortion contraception. The study also highlighted that depot provera was the most accepted contraception. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 14-17 DOI: http://dx.doi.org/10.3126/njog.v8i1.8854

Prevalence and determinants associated with second trimester termination of pregnancy in Harari city, Ethiopia; Cross sectional study.

2021 ◽  
Author(s):  
Murad Mohammed ◽  
Million Wesenu
Keyword(s):  
Logistic Regression ◽  
Cross Sectional Study ◽  
Termination Of Pregnancy ◽  
Reproductive Age ◽  
Second Trimester ◽  
Sectional Study ◽  
Cross Sectional ◽  
Abortion Care ◽  
Post Abortion ◽  
Age Category

Abstract Background: Abortion is a termination of pregnancy before the fetus has become viable, i.e., capable of independent existence once delivered by the mother. The purpose of this study was to assess the prevalence and determinants associated with second trimester termination of pregnancy among the women in the reproductive age. Methods: Cross sectional study, design was conducted from September 1-30, 2020. Eight hundreds thirty-five sample of women with induced abortion complication were used. The data were entered into statistical package and service solutions (SPSS) version 23.0 for cleaning and data analysis. Chi-square test of association was used to test the association between the response variable. Binary logistic regression was employed for variables one by one in bivariate logistic regression to determine the significant association between response variables and predictors at p-value 0.15. A 95% confidence interval (CI) and level of significance less than 0.05 were used to determine statistical significance. Results: The prevalence of second trimester termination of pregnancy in the reproductive Age (15-49 years) was found to be 18.2%. As a result multivariable logistic regression model, women with age category 20-24 years [Adjusted odds ratio(AOR)=2.055, 95% CI=1.102-3.831], age category 30-34 years [AOR=3.084, 95%CI=1.348-7.056] , age category greater than or equal to 35 had adjusted odds ratio(AOR=3.021, 95% CI=1.199-7.610), having safe abortion care (AOR=0.294, 95%CI=0.132-0.656), taking treatment in health care/hospital (AOR=2.385, 95% CI=1.057-5.382) and repeatedly acceptor of post-abortion contraception (AOR=0.533, 95%CI=0.291-0.979) were potential determinants associated with women’s in the reproductive age with second trimester termination of pregnancy. Conclusions: Second trimester termination of pregnancy is strongly affected by age of mother, abortion care, place of managed abortion and post-abortion contraception. Strategies on Antenatal care and task-oriented services should be given to community level about the second trimester medical termination of pregnancy to decrease further complications and maternal mortality.

scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results: We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children. Conclusion: This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.

scholarly journals The infrastructural capacity of Ghanaian health facilities to provide safe abortion and post-abortion care: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Easmon Otupiri ◽  
Chelsea B. Polis ◽  
Roderick Larsen-Reindorf
Keyword(s):  
Scale Up ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Safe Abortion ◽  
Signal Functions ◽  
Rural Location ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background Ghana is one of few countries in sub-Saharan Africa with relatively liberal abortion laws, but little is known about the availability and quality of abortion services nationally. The aim of this study was to describe the availability and capacity of health facilities to deliver essential PAC and SAC services in Ghana. Methods We utilized data from a nationally representative survey of Ghanaian health facilities capable of providing post-abortion care (PAC) and/or safe abortion care (SAC) (n = 539). We included 326 facilities that reported providing PAC (57%) or SAC (19%) in the preceding year. We utilized a signal functions approach to evaluate the infrastructural capacity of facilities to provide high quality basic and comprehensive care. We conducted descriptive analysis to estimate the proportion of primary and referral facilities with capacity to provide SAC and PAC and the proportion of SAC and PAC that took place in facilities with greater capacity, and fractional regression to explore factors associated with higher structural capacity for provision. Results Less than 20% of PAC and/or SAC providing facilities met all signal function criteria for basic or comprehensive PAC or for comprehensive SAC. Higher PAC caseloads and staff trained in vacuum aspiration was associated with higher capacity to provide PAC in primary and referral facilities, and private/faith-based ownership and rural location was associated with higher capacity to provide PAC in referral facilities. Primary facilities with a rural location were associated with lower basic SAC capacity. Discussion Overall very few public facilities have the infrastructural capacity to deliver all the signal functions for comprehensive abortion care in Ghana. There is potential to scale-up the delivery of safe abortion care by facilitating service provision all health facilities currently providing postabortion care. Conclusions SAC provision is much lower than PAC provision overall, yet there are persistent gaps in capacity to deliver basic PAC at primary facilities. These results highlight a need for the Ghana Ministry of Health to improve the infrastructural capability of health facilities to provide comprehensive abortion care.

scholarly journals Quality Of Post-Abortion Care In Java, Indonesia: An Essential Services Analysis 

2020 ◽  
Author(s):  
Jesse Philbin ◽  
Nugroho Soeharno ◽  
Margaret Giorgio ◽  
Rico Kurniawan ◽  
Meghan Ingerick ◽  
...  
Keyword(s):  
Health System ◽  
First Trimester ◽  
Health Centers ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Dilation And Curettage ◽  
Essential Services ◽  
Post Abortion

Abstract Background High maternal mortality in Indonesia persists despite economic growth and a reform that extended health insurance to all Indonesians. Quality of obstetric health services, in general, has been identified as a factor for this; in addition, the country’s restrictive abortion laws merit special attention to the quality of post-abortion care (PAC) services. Methods Using data from a survey of 657 hospitals and emergency obstetric-registered public health centers in Java, Indonesia’s most populous island, we used the essential services framework to measure the health system’s capacity to offer PAC. We then used this framework to explore how Java’s capacity to offer PAC could change given two hypothetical reforms. Finally, we calculated the proportion of PAC patients treated using each of four different procedures. Results No emergency obstetric health centers (PONEDs) are adequately staffed or authorized to offer basic PAC services, while 46% of all hospitals in Java have the full set of services needed. These proportions increase in hypothetical scenarios in which PAC authorization is expanded to midwives, general physicians, and PONED facilities. Eighty-eight percent of PAC patients were treated using dilation and curettage (D&C). Conclusions Allowing clinicians other than Ob/Gyns to perform uterine evacuation and offering first-trimester PAC service in PONEDs would greatly improve the capacity of Java’s health system to serve PAC patients. Increasing the use of vacuum aspiration and misoprostol would lower the burden of treatment for patients, reduce costs to the health system, and facilitate the task-shifting efforts needed to expand access to this life-saving service.

scholarly journals Factors Associated with Unsafe Induced Abortion among Women who attended Fitche Hospital, Oromia, Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Abebe Feyissa Amhare ◽  
Dereje Gobena Alemayehu ◽  
Alemtsehay Adam Bogale
Keyword(s):  
Care Service ◽  
Traditional Birth Attendant ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Induced Abortion ◽  
Sectional Study ◽  
Cross Sectional ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion

Abstract Background Unsafe induced abortion is one of the most medical and public health problems in developing countries including Ethiopia. Ethiopia has permitted abortion in specific legal circumstances when the conception of the fetus is caused by rape, incest, when continuation of pregnancy endangers the mother’s life. The aim of this study is to assess the magnitude and associated risk factors of unsafe induced abortion among women who received post abortion care service in Fitche Hospital. Methods Institutional based cross-sectional study was carried out among women who received post abortion care service at Fitche hospital from November 30, 2017 up to May 30, 2018. The data was collected using pre tested questionnaire and entered to EpiData version 3.1 software and analyzed using SPSS version 24. Descriptive statistics, multivariate logistic regression analysis and chi-square test were conducted. Results Three hundred and eight respondents (100% response rate) with mean age of 30 ± 9 years were participated in this study. From respondents, 45% had history of unsafe induced abortion and 27% of them reported the abortion was performed in house by traditional birth attendant. Single women were more likely practice unsafe induced abortion than widowed women [OR: 9.71; 95%CI (1.30 – 72.42)]. Women who had low monthly income [OR: 6.72; 95%CI (2.15 - 20.97)] and house wives [OR: 12.29; 95%CI (1.70 - 88.63)] were more likely practice unsafe induced abortion than counterparts. Failure of contraceptive methods, place of interference, method used for interference, a person who induced the abortion, a condition after procedure, and reasons to induce abortion were identified as association factors of unsafe induced abortion at P < 0.001. Conclusion The study assessed the magnitude and reported a significant association between unsafe induced abortion and socio-demographic factors, contraceptive practice, and abortion related items. These findings are positive enough to warrant a large-scale study to better understand the unsafe abortion vulnerability factors in Ethiopia.

scholarly journals Health system capacity for post-abortion care in Java, Indonesia: a signal functions analysis

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Jesse Philbin ◽  
Nugroho Soeharno ◽  
Margaret Giorgio ◽  
Rico Kurniawan ◽  
Meghan Ingerick ◽  
...  
Keyword(s):  
Health System ◽  
First Trimester ◽  
Health Centers ◽  
Signal Functions ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Maternity Hospitals ◽  
Referral Hospitals ◽  
Post Abortion

Abstract Background The quality of obstetric care has been identified as a contributing factor in Indonesia’s persistently high level of maternal mortality, and the country’s restrictive abortion laws merit special attention to the quality of post-abortion care (PAC). Due to unique health policies and guidelines, in Indonesia, uterine evacuation for PAC is typically administered only by Ob/Gyns practicing in hospitals. Methods Using data from a survey of 657 hospitals and emergency obstetric-registered public health centers in Java, Indonesia’s most populous island, we applied a signal functions analysis to measure the health system’s capacity to offer PAC. We then used this framework to simulate the potential impact of the following hypothetical reforms on PAC capacity: allowing first-trimester uterine evacuation for PAC to take place at the primary care level, and allowing provision by clinicians other than Ob/Gyns. Finally, we calculated the proportion of PAC patients treated using four different uterine evacuation procedures. Results Forty-six percent of hospitals in Java have the full set of services needed to provide PAC, and PAC capacity is concentrated at the highest-level referral hospitals: 86% of referral hospitals have the full set of services, staffing, and equipment compared to 53% of maternity hospitals and 34% of local hospitals. No health centers are adequately staffed or authorized to offer basic PAC services under Indonesia’s current guidelines. PAC capacity at all levels of the health system increases substantially in hypothetical scenarios under which authorization to perform first-trimester uterine evacuation for PAC is expanded to midwives and general physicians practicing in health centers. In 2018, 88% percent of PAC patients were treated using dilation and curettage (D&C). Conclusions Offering first-trimester uterine evacuation for PAC in PONEDs and allowing clinicians other than Ob/Gyns to perform this procedure would greatly improve the capacity of Java’s health system to serve PAC patients. Increasing the use of vacuum aspiration and misoprostol for PAC-related uterine evacuation would lower the burden of treatment for patients and facilitate the task-shifting efforts needed to expand access to this life-saving service.

scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background Women working in Cambodian garment factories have unmet needs for contraception and safe abortion services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results We interviewed 16 women and 13 providers between August and November 2018. Most women were married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to side effects and misconceptions related to with modern contraception. Fear of infertility was particularly reported among young women without children.Conclusion This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work needs to address this gap by developing appropriate and effective interventions and informative tools for women in the Cambodian garment industry.

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