Abstract
BackgroundDespite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to investigate the prevalence of abortion, the reasons women had abortions, median years to first abortion after sexual debut and examine the factors of time to first abortion among women of reproductive age in the Republic of Congo.MethodsWe used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3622 women aged 15–49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p < 0.05.Results60% of pregnancies which are terminated are as a result of induced abortion and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34, 67, 86 and 94% higher risk of abortion respectively, when compared with women from poorest households (all p < 0.05). Women currently in union/living with a man and formerly in union had 41 and 29% reduction in the risk of abortion respectively, when compared with those never in union (all p < 0.05). In addition, women with primary and secondary+ education had 42 and 76% higher risk of abortion respectively, when compared with women with no formal education (all p < 0.05).ConclusionThere was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.
Highlights
Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries
In light of the above, we aimed to investigate the prevalence of abortion, the reasons women had abortions, median years to first abortion after sexual debut and examine the factors of time to first abortion among women of reproductive age in the Republic of Congo
We identified a high prevalence of abortion with short years interval between age at sexual debut and time at first abortion
Summary
Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. The global maternal mortality ratio (MMR) reduced to 216 in 2015 from 385 deaths per 100,000 livebirths in 1990 [1]. Abortion is a known cause of maternal death [2] It may be either safe or results in complications and death [3]. Unsafe abortion accounts for over 60,000 maternal deaths annually [4], and causes disabilities in about 5 million women due to complications [5]. About 8% of maternal deaths was reported to be due to abortion and among those deaths, complications from unsafe abortion are one of the most common and preventable and curable causes [2, 6]. The objectives of global strategy include to end preventable deaths, ensure health and well-being and expand enabling environments
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