A retrospective study on causes of unsafe abortions in referred patients, at a tertiary care centre in western Uttar Pradesh

Background: Unsafe abortions occur when pregnancy is terminated by unqualified person or in an environment that do not conform to minimal medical standards or both. The aim of this study was to analyse the causes in referred patients of unsafe abortions, methods used and complications with which patients were admitted.Methods: A retrospective observational study conducted in the department of Obstetrics and Gynaecology, SIMS Hapur Uttar Pradesh, India from 1stJune 2019 to 29thFebruary 2020. Data was collected from previous hospital records. Total 150 women aged between 18-40 years, admitted with complications of unsafe abortions and who had taken advice for termination outside our institute, were included. The demographic profile, detailed history, first contact person for abortion advice, abortion service provider, method of termination and prior ultrasound were noted. Exclusion criteria was period of gestation more than 20 weeks and spontaneous abortions.Results: The study showed 92% contacted unqualified person, out of which 22.5%were uncertified doctors, 30.4% ANM’s, 16.7% Nurses, 12.3% consulted quacks and 10.9% Chemists. Among the abortion service providers 23.6% were uncertified doctors, 45.7% Chemists, 15% Nurses, 5.7% Quacks, 3.6% ANM’s and 6.4% had taken self-medication. Prior ultrasound was done in 28% cases. Method of termination was medical in 78.7% and surgical in 21.3% cases. Period of gestation was <8 weeks in 69.3%, 8-12 weeks in 27.3%, 12-16 weeks in 2%. 37.3% had parity 2 and 55.3% were Hindus.Conclusions: Despite availability of safe abortion services, unsafe abortion practices are still prevalent. Approved MTP centres, skilled and certified abortion providers must be easily accessible to women even in rural areas to safeguard their health.

Post Abortion Contraceptive Use And Determinant Factors In Ethiopia: A Systematic Review And Meta Analysis

Background: World health organization recommendations are aimed to provide comprehensive post abortion care for all women coming for abortion services. Different investigations have been conducted in Ethiopia reporting the prevalence and the determinant factors of post abortion contraception, but they lacks consistency and are characterized by discrepancy. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and associated factors of family planning utilization among women receiving abortion service in Ethiopia. Methods: A systematic review and Meta-analysis of published and grey literature were assessed. The protocol was registered on PROSPERO at CRD42020162969. PubMed, Google Scholar, Science Direct, HINARI and Cochrane Library and Google were used to review studies starting from January 14, 2020 to March 11, 2020. STATA 14 software was used for analysis. JBI approach was used for critical appraisal, study selection, data extraction. The possible risk of publication bias was examined using the Funnel plot, Begg’s and Egger’s test. Statistical heterogeneity was quantified using Cochran’s Q and the I2 test statistic. Random effect model was used as a method of analysis. Result: A total of 8236 women were involved using sixteen studies having 7 to 9 quality scores. The pooled prevalence of family planning utilization among women receiving abortion service in Ethiopia was 69.73% (95% CI: 63.67,75.79) .In addition, subgroup analysis showed the highest prevalence of post abortion contraception on Addis Ababa city Administration ,79.38(95%CI;66.87,91.89).Counseling for contraceptive: (OR=3.48,95% CI: 1.94,6.25), history of contraceptive use: (OR=7.62, 95% CI: 3.28:17.69) have shown a positive association with post abortion family planning use in Ethiopia. Conclusion: Family planning utilization among women receiving abortion service is shown to be less than the WHO and national recommendation. Counseling and history of contraceptive use were found to be significantly associated with post abortion family planning utilization in Ethiopia. Conclusion: Family planning utilization among women receiving abortion service is shown to be less than the WHO and national recommendation. Counseling and history of contraceptive use were found to be significantly associated with post abortion family planning utilization in Ethiopia.

Post-abortion Family Planning Utilization and Associated Factors among Women Seeking Abortion Service: Cross-sectional Study

Background: Ethiopia is one of the developing countries with a high prevalence of unintended pregnancy and unsafe abortion. The aim of this study was to assess the utilization of post-abortion family planning and associated factors among women seeking abortion service in Asella Town health facilities, 2019. Methods: A facility based cross-sectional study design was conducted among women who came for abortion service from July 15 to October 15, 2019. Two hundred seventy-six participants were included using systematic random sampling technique. Both descriptive and logistic regression analyses were conducted. In multivariate analysis, variables which had a p-value < 0.05 was considered as significantly associated with the outcome variable. Results: Postabortion family planning utilization among study participants was 146 (53.7%) (95% CI=47.4, 59.2). Formal education (AOR=4.45: 95% CI: (1.18, 16.74)), previous history of abortion (AOR=0.35; 95% CI: (0.14, 0.85)), positive attitude to towards family planning (AOR=2.62; 95% CI: (1.09, 6.27)) and counseled on post abortion family planning utilization (AOR=3.12; 95% CI: (1.30, 7.51)) were significantly associated with post abortion family planning utilization. Conclusions: In this study, nearly fifty percent of the respondents did not utilize Postabortion Family Planning (PAFP). Educational status, history of pervious abortion, a decision when to have a child, attitude toward PAFP utilization and counseling about PAFP were significantly associated with post-abortion family planning utilization. The health care providers who give abortion service should give counseling for all women who get abortion service. More accents should be given to misperception of PAFP to change the negative attitude of utilization of PAFP.