Abstract
BackgroundUnsafe abortion is a leading cause of death among young women aged 10–24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12–24 years seeking abortion-related care in Kenya.MethodsWe used data on 1,378 young women aged 12–24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form.ResultsNine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %).ConclusionsOur study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion care service providers must ensure that young clients receive contraceptive counseling and effective pregnancy prevention methods before discharge from the health care facility to prevent unintended pregnancies that may result in subsequent induced abortions.
Highlights
Unsafe abortion is a leading cause of death among young women aged 10–24 years in sub-Saharan Africa
Kenya’s restrictive abortion laws and the high stigma around premarital sexual activity, which limits access to sexual and reproductive health services and effective contraception, mean that many young women with unintended pregnancies resort to unsafe abortion
We examine the factors associated with the likelihood of reporting a previous induced abortion among young females aged 10–24 years receiving abortion-related care in Kenya
Summary
Unsafe abortion is a leading cause of death among young women aged 10–24 years in sub-Saharan Africa. An estimated 6.4 million abortions occurred in Africa in 2008 [1]. Young women aged 10–24 years are at heightened risk for unsafe abortion due to their high vulnerability to unintended pregnancies [6,7,8,9]. Kenya’s restrictive abortion laws and the high stigma around premarital sexual activity, which limits access to sexual and reproductive health services and effective contraception, mean that many young women with unintended pregnancies resort to unsafe abortion. Young females form the bulk of women who present for care following unsafe abortion in Kenya [11]. Limited uptake of effective contraceptive methods after an abortion [11] may place many young women at risk for subsequent unintended pregnancies and abortion
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