RESEARCH PAPER
Determinants of induced abortion among second-trimester pregnant women attending Dessie City health facilities, Northeast Ethiopia: a case-control study
 
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1
Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
 
2
Department of Population and Family Health, Institution of Health, Faculty of Public Health, Jimma, Ethiopia
 
3
Department of Epidemiology and Biostatics, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
 
4
Department of Epidemiology and Biostatics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
 
 
Submission date: 2022-09-05
 
 
Final revision date: 2022-12-22
 
 
Acceptance date: 2023-01-02
 
 
Online publication date: 2024-10-23
 
 
Corresponding author
Elsabeth Addisu   

Wollo university
 
 
HIV & AIDS Review 2024;23(4):342-348
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Globally, 10-15% of induced abortions occur in the second-trimester period, over half of which is considered unsafe, and disproportionately contribute to maternal deaths. However, there are limited information about determinants of induced abortion in second-trimester in the country, particularly in the study area. Therefore, this study aimed to identify determinants of induced abortion in the second-trimester.

Material and methods:
Unmatched case-control study was conducted in Dessie City Northeast Ethiopia from January to March 2019. A total sample of 390 patients were included in the study, with a ratio of 1 : 2 (case : controls). Data were assessed in Epi data version 3.1 and analyzed with SPSS version 25. Multivariable logistic regression model was applied to identify determinants of induced abortion. Adjusted odds ratio with 95% confidence interval (CI) was used to measure the effect size of predictors.

Results:
The mean age of cases was 25 years (± 6.6) and 29.3 years (± 5.3) of controls. Seventy six (58.5%) cases were not currently married compared with 19 (7.3%) controls. Study participants who were currently not married (AOR = 10.82; 95% CI: 5.01-23.36%), having poor knowledge about induced abortion (AOR = 3.03; 95% CI: 1.46-6.26%), uncertainty about last normal menstrual period (AOR = 4.12; 95% CI: 2.01-8.44%), late pregnancy testing (AOR = 5.94; 95% CI: 2.5-14.15%), not using contraceptives (AOR = 3.70; 95% CI: 1.85-7.44%), having irregular menstrual cycle (AOR = 4.83; 95% CI: 2.41-9.70%), and three and more live births (AOR = 0.25; 95% CI: 0.11-0.59%) were independent predictors of induced abortion in the second-trimester.

Conclusions:
This study identified several factors correlated with women having induced abortions in the second-trimester. It may be helpful for the government of Ethiopia to encourage the effort to improve healthcare counselling on reproductive health-related issues, and planning of interventions focusing on behavioral changes and social marketing as well as providing information to young adolescents on their sexuality to minimize pre-marital sex.

REFERENCES (20)
1.
Lee VC, Ng EH, Ho P. Issues in second trimester induced abortion (medical/surgical methods). Best Pract Res Clin Obstet Gynaecol 2010; 24: 517-527.
 
2.
World Health Organization. Facts on induced abortion world­wide. 2012. Available from: http://www.who.int/reproductiv... pdf.
 
3.
Denberu B, Alemseged F, Segni H. Determinants of abortion among youth seeking reproductive health care in selected health facilities, in Addis Ababa, Ethiopia. Global J Reprod Med 2017; 1: 27-38.
 
4.
Planned Parenthood Federation of America. Abortion after the first trimester in the United States. Washington DC: Planned Parenthood Federation of America Inc.; 2004.
 
5.
Mulat A, Bayu H, Mellie H, Alemu A. Induced second trimester abortion and associated factors in Amhara region referral hospitals. Biomed Res Int 2015; 2015: 256534. DOI: 10.1155/2015/256534.
 
6.
Muyuni LM, Vwalika B, Ahmed Y. Determinants and outcomes of second trimester abortions at the University Teaching Hospital. Med J Zambia 2014; 41: 37-47.
 
7.
Harries J, Orner P, Gabriel M, Mitchell E. Delays in seeking an abortion until the second trimester: a qualitative study in South Africa. Reprod Health 2007; 4: 7. DOI: https://doi.org/10.1186/1742-4....
 
8.
Federal Democratic Republic of Ethiopia Ministry of Health. National Reproductive Health Strategy. 2016.
 
9.
Ushie BA, Izugbara CO, Mutua MM, Kabiru CW. Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data. BMC Womens Health 2018; 18: 41. DOI: https://doi.org/10.1186/s12905....
 
10.
Grossman D, Blanchard K, Blumenthal P. Complications after second trimester surgical and medical abortion. Reprod Health Matters 2008; 16 (Suppl 31): 173-182.
 
11.
Dessie city health office. Dessie city health office health facility profile. 2018.
 
12.
de Toledo M, Drezett J, Machi GS, Pereira VX, Raimundo RD, Oliveira FR, et al. Factors associated with the delay in seeking legal abortion for pregnancy resulting from rape. Int Arch Med 2015; 8. DOI: 10.3823/1628.
 
13.
Bonnen KI, Tuijje DN, Rasch V. Determinants of first and second trimester induced abortion-results from a cross-sectional study taken place 7 years after abortion law revisions in Ethiopia. BMC Pregnancy Childbirth 2014; 14: 416. DOI: 10.1186/s12884-014-0416-9.
 
14.
Jones RK, Finer LB. Who has second-trimester abortions in the United States? Contraception 2012; 85: 544-551.
 
15.
Gallo MF, Nghia NC. Real life is different: a qualitative study of why women delay abortion until the second trimester in Vietnam. Soc Sci Med 2007; 64: 1812-1822.
 
16.
Drey EA, Foster DG, Jackson RA, Lee SJ, Cardenas LH, Darney PD. Risk factors associated with presenting for abortion in the second trimester. Obstet Gynecol 2006; 107: 128-135.
 
17.
Ingham R, Lee E, Clements SJ, Stone N. Reasons for second trimester abortions in England and Wales. Reprod Health Matters 2008; 16 (Suppl 31): 18-29.
 
18.
Svensson E, Ehrenstein V, Nørgaard M, Bakketeig LS, Rothman KJ, Sørensen HT, et al. Estimating the proportion of all observed birth defects occurring in pregnancies terminated by a second-trimester abortion. Epidemiology 2014; 25: 866-871.
 
19.
Worku S, Fantahun M. Unintended pregnancy and induced abortion in a town with accessible family planning services: the case of Harar in eastern Ethiopia. Ethiopian Journal of Health Development 2006; 20: 79-83.
 
20.
Foster DG, Jackson RA, Cosby K, Weitz TA, Darney PD, Drey EA. Predictors of delay in each step leading to an abortion. Contraception 2008; 77: 289-293.
 
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ISSN:1730-1270
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