Ghana abortion care—a model for others: analysis of the 2017 Ghana Maternal Health Survey

Abstract

BackgroundAbout 5-13% 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. ObjectiveOur study's primary aim was to characterize abortion outcomes in Ghana. Our secondary aims include observing for reasons leading to abortion complications and treatment of these complications. Study DesignWe utilized data from the 2017 Ghana Maternal Health Survey. We examined questions focusing on reasons for abortion, methods used for abortion, healthcare setting for abortion, and health issues post-abortion. We performed descriptive and inferential statistics including cross tabs with chi-square analysis and logistic regression models. ResultsBetween 2012 and 2017, 1,425 women reported and completed the abortion-related questions. For those obtaining an abortion for health reasons, 69% had a surgical compared to herbal or medication-based abortion (p<0.001), 94% had a medical compared to non-medical facility-based abortion (p<0.001), and 21% had health problems related to the abortion within one month (p=0.035). Women's reasons for receiving an abortion did not affect treatment rates after complications. There was no difference in medical-based versus non-medical based abortion and regarding the occurrence of an abortion-related complication, or receipt of treatment for this complication within one month after the abortion. Those with a tertiary level of education or who know abortions are legal were more likely to have a surgical and medical facility-based abortion. ConclusionWhile 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, appear safe. Translating Ghana's approach to abortion could minimize unsafe abortions globally.