Abstract
Background The incidence of abortion in Ghana ranges from 27 per 1000 to 61 per 1000 women, causing gynecological complications and maternal mortality. The use of modern contraceptives and its associated factors among women aged 15–49 years have been documented. However, utilization of modern contraceptives specifically among women with induced abortion history is underreported. This study therefore aimed at determining the proportion and identifying predictors of contraceptives use in this underreported population. Methods This study used secondary data from the 2017 Ghana Maternal Health Survey (GMHS) for the analysis. The analysis is on a weighted sample of 3,039 women aged (15–49 years) with a history of induced abortion. Both descriptive and inferential methods were employed. The chi-square test, univariate and multivariate logistic regression techniques were used to assess statistical associations between the outcome variable and the predictors. Statistical significance was set at 95% confidence interval and p values ≤0.05. Results Out of the 3,039 participants, 37% (95% CI: 34.6, 38.84) used contraceptives. We identified women' age, union, place of residence, knowledge of fertile period, total pregnancy outcomes, and region as strong significant (95% CI, p ≤ 0.05) predictors of post induced abortion contraceptives use. Conclusion Contraceptives use among this vulnerable population is low. Therefore, there is a need to provide widespread access to postabortion contraception services and enhance efforts to efficiently integrate safe abortion practices law into health services in Ghana.
Highlights
The proportion of unsafe abortions in developing countries is 49.5% [1]
Interviews were completed with 25,062 women. e response rate of the completed interview was 99%. e sampling procedure is extensively detailed in the complete final report of the Ghana Maternal Health Survey 2017 (ICF, Ghana Health Service (GHS), 2018) [21]
Almost 37% of the participants used contraceptives. e mean and standard deviation age in years of respondents using contraceptives was 33.11 (8.09). e participants who had education above primary school level were 73.43%
Summary
The proportion of unsafe abortions in developing countries is 49.5% [1]. Sub-Saharan Africa (SSA) accounts for 61% of all deaths due to unsafe abortion with a case fatality rate for Africa in 2008 approximated at 520 per 100,000 unsafe abortions [2]. In Ghana, 20% of women in reproductive age (15–49 years) have experienced induced abortion during their lifetime (ICF, Ghana Health Service (GHS), 2018). Despite the 1985 Ghanaian law accommodating safe abortion practice on certain medicosocial grounds, there have been observed delays in the formulation and implementation of policies to integrate the law into health services [5]. Factors such as lack or insufficient knowledge on safe abortion, stigma related to unintended pregnancy, religious beliefs, and implicit nature of the abortion law have significantly influenced safe abortion practice negatively in Ghana [5, 6]
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