Safe Abortion Services Research Articles

Characteristics and Outcomes of Abortion Cases at a Tertiary Care Hospital in Bangladesh

Introduction: Abortion is a critical public health issue, particularly in developing countries like Bangladesh, where access to safe abortion services is often limited. This study aimed to analyze the characteristics and outcomes of abortion cases in a tertiary-level hospital setting, providing insights into the demographic profile of patients, nature and type of abortions, treatment methods, and post-abortion complications. Methods: This cross-sectional observational study was conducted at the department of Obstetrics and Gynecology, Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh, from June 2022 to July 2023. A total of 100 patients were consecutively sampled based on specific inclusion and exclusion criteria. Data were collected through patient medical records and interviews, focusing on demographic information, details of the abortion, and subsequent outcomes. Result: The majority of patients were in the 26-30 age group (42%), with 58% being primigravida. Most abortions occurred in the early stages of pregnancy (<13 weeks, 75%). Incomplete abortions were the most common type (83%), and the majority of cases were spontaneous (84%). Surgical intervention (D&C) was the predominant treatment method (83%). While most patients (84%) did not experience complications, a minority faced significant health challenges, including shock (5%) and septicemia (3%). Conclusion: The study highlights a high incidence of incomplete abortions and a preference for surgical treatment in abortion cases at the tertiary hospital level in Bangladesh. These findings underscore the need for improved abortion care, enhanced patient education, and better access to comprehensive abortion services. The study's insights are crucial for informing policy and practice to improve reproductive health services and address the challenges of unsafe abortion practices in Bangladesh.

“I wasn’t sure it would work. I was just trying”: an ethnographic study on the choice of abortion methods among young women in Kilifi County, Kenya, and Atlantique Department, Benin

BackgroundDespite the increased availability of safe abortion methods in sub-Saharan Africa, women and girls continue to use unsafe abortion methods and procedures to terminate their unwanted pregnancies, resulting in severe complications, lifelong disabilities, and death. Barriers to safe abortion methods include restrictive laws, low awareness of safe abortion methods, poverty, and sociocultural and health system barriers. Nonetheless, there is a paucity of data on the decision-making around and use of abortion methods. This paper aims to provide answers to the following questions: Which abortion methods do women and girls use and why? Who and what influences their decisions? What can we learn from their decision-making process to enhance the uptake of safe abortion methods? We focus our in-depth analysis on the rationale behind the choice of abortion methods used by women and girls in Kilifi County in Kenya and Atlantique Department in Benin.MethodsWe draw on data collected as part of an ethnographic study conducted between January and August 2021 on lived experiences, social determinants, and pathways to abortion. Data were collected using repeated in-depth interviews with 95 girls and women who had a recent abortion experience. Data from the interviews were supplemented using information from key informant interviews, focus group discussions, and participant observation. Data analysis was conducted through an inductive process.ResultsOur findings reveal that women and girls use various methods to procure abortions, including herbs, high doses of pharmaceutical drugs, homemade concoctions, medical abortion drugs, and surgical abortion methods. Procedures may involve singular or multiple attempts, and sometimes, mixing several methods to achieve the goal of pregnancy termination. The use of various abortion methods is mainly driven by the pursuit of social safety (preservation of secrecy and social relationships, avoidance of shame and stigmatization) instead of medical safety (which implies technical safety and quality).ConclusionOur findings reaffirm the need for comprehensive access to, and availability of, abortion-related information and services, especially safe abortion and post-abortion care services that emphasize both medical and social safety.

Hostilities faced by people on the frontlines of sexual and reproductive health and rights: a scoping review

Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for...

To Asses Maternal Morbidity and Mortality of Induced Abortion among Admitted Cases in Rajshahi Medical College Hospital, Rajshahi

Background: Abortion is pregnancy termination before the 24th week. Unsafe induced abortions, lacking proper skills or medical standards, cause 67,000 annual deaths in developing countries, according to WHO. Ensuring access to safe and legal abortion services is critical to reducing maternal mortality and safeguarding women's health globally. Objectives: The aim of this study was to find out maternal mortality as well as morbidity related to induce abortion for termination of unwanted pregnancy in our set up. Methods: A cross-sectional study was conducted on 92 patients who admitted as cases of induced abortion in Rajshahi Medical College Hospital from March' 2014 to September 2014Those who had given informed written consent was finally enrolled in this study. Patients' details history, clinical examination investigation, and operation note was collected in a preformed data sheet. Data was presented in the form of tables and graphs. Data was presented with descriptive statistics the level of significance of 0.05 was used for this study. Results: Among 92 patients were 15(16.3%) hemorrhage, 9(9.8%) hypovolemic shock, 10(10.9%) generalized peritonitis, 34(36.9%) pelvic peritonitis5 (5.4%) perforation of uterus, 4(4.3%) cervical injury, 1(1.1%) perforation of gut, 2(2.2%) septic shock, 2(2.2%) acute renal failure, 10(10.9%) no major complication. Among 92 patient 86 (93.5%) patients were improved and discharged and 6(6.5%) patients were expired. Conclusion: Induced abortion is a common gynecological problem requiring hospital admission and treatment. It has serious short term and long-term complications affecting women's health and life.

Impact of the Covid-19 Pandemic on the Prevalence of MTP Cases and Their Clinicodemographic Profile in India: A Retrospective Multicentric Study.

During the Covid-19 pandemic, reproductive health of women was disproportionately affected due to difficult access to safe abortion and contraceptive services. This study aims to assess the impact of the Covid-19 pandemic on the prevalence of MTP cases and to find out the clinicodemographic profiles of women undergoing MTP during three Covid-waves in different hospitals-Government and private sectors in India. This retrospective multicentric cohort study was conducted during three Covid-19 pandemic waves. The records were retrieved from the centers' medical record section and the MTP register from the Department of Obstetrics and Gynaecology. On an average, 1.1 women/day underwent MTP during covid waves compared to 1.9 women/day during the pre-covid 2019. The first Covid wave's average MTP/day was very low (0.71) compared to the third (2.88) and second wave (1.12), respectively. These differences were statistically significant (p<0.0001). The most common indication for MTP was contraceptive failure 245(50.9%), followed by eugenic/congenital anomalies 88(18.9%). A total of 244 cases (50.6%) reported for MTP ≤ seven weeks and 114(23.6%) presented between 7 and 12 weeks. More than half (54%) of the women underwent surgical methods for abortion as the unavailability of medical abortion (MA) drugs. IUCD and sterilization were severely affected during the first and second Covid waves. Safe abortions are essential services for reproductive-age women. With the uncertainty of future Covid-like an emergency, we should strengthen our telemedicine network so that women can reach out early and MMA can be initiated to reduce the number of surgical abortions and unwanted pregnancies.

Reproductive Justice as a Framework for Abortion Care.

This article presents an in-depth analysis of abortion access and rights within the Reproductive Justice framework, underscoring the health, social, and economic consequences of limited access. It emphasizes the critical role of abortion as essential, safe health care and highlights the complexities surrounding abortion decisions and the barriers faced by poor and historically marginalized populations. Amid the escalating access restrictions, the article concludes with a call to action for obstetricians and gynecologists and our allied health care providers to recognize, support, and advocate for safe, legal, and affordable abortion services as fundamental to health care equity and human rights.

Knowledge, attitude, and intended practice of abortion among pharmacy students in Thailand after the amendment of the Thai Abortion Law

BackgroundThe recently amended Thai abortion law allows pregnant women to undergo abortions up to the gestational age of 12 weeks. Medical abortion is significant because it has revolutionized access to safe abortion care—abortion medicine can now be safely and effectively administered outside of a healthcare facility to women in early pregnancy. This contribution supports the pharmacists’ role in interprofessional safe abortion teamwork. Adequate knowledge of the current laws regarding safe abortion services will increase pharmacists’ competence in providing services. However, safe abortions as a subject have not been formally incorporated into the curriculum for Thai pharmacy students. Therefore, this study aimed to evaluate the knowledge, attitude, and intended practice of fifth-year pharmacy students at Chulalongkorn University.MethodsA cross-sectional study was conducted using an electronic self-administered questionnaire adapted from previously published studies to evaluate participants’ knowledge of the recently amended Thai abortion law, attitude toward abortion, and intended practices. The invitations were sent to all fifth-year pharmacy students at Chulalongkorn University.ResultsAmong all invitations sent, 104/150 (69.3%) participants responded to the survey. Only a third of the participants (31.7%) had good knowledge scores. Based on five questions regarding the gestational age limit for legal abortion, most participants (52.7%) answered questions incorrectly. Although more than half of the participants (52.5%) disagreed with two pro-choice statements, an overwhelming majority (87.5%) agreed that abortion was a woman’s right. Safe abortion services were mostly agreed upon with serious fetal defects (91.9%), non-HIV maternal health conditions (82.2%), and sexual assaults (77.4%). A positive attitude toward abortion affects the intention to perform an abortion under socioeconomic conditions.ConclusionMost participants lacked knowledge on the amended abortion law, especially on the gestational limits of abortion. Participants with favorable attitudes toward abortion tended to be more liberal regarding safe abortion services.

Relationship of Mother Characteristics with Abortion Behavior in PKBI Clinic East Java Province

Background: Abortion is one of the important issues that must be considered. This problem gets important attention in health problems because it affects the birth rate and maternal mortality. One of the factors that cause unsafe abortion is the lack of safe abortion services. Objective: To analyze the relationship between maternal characteristics and abortion behavior at PKBI clinics in East Java province. Methods: This type of research is analytic using a cross sectional design. Samples from 186 couples of childbearing age were taken randomly. Data collection used secondary data obtained from medical records of patients accessing abortion services at the PKBI clinic in East Java province. Data analysis used logistic regression. Results: The results showed the relationship between birth spacing (p = 0.001), mother's occupation (p = 0.00), contraceptive use (p = 0.00), history of miscarriage (p = 0.00), gestational age (p = 0.00), reasons for abortion (p = 0.00). = 0.00), family dependents (p = 0.004) with the behavior of couples of childbearing age who had an abortion, while maternal age (p = 0.273), parity (p = 0.341), maternal education (p = 0.069) did not have a relationship with the behavior of age couples fertile who had an abortion. Conclusion: birth spacing, mother's occupation, use of contraception, history of miscarriage, gestational age, reasons for abortion, and family responsibilities have a very large effect on abortion.

Accessibility of family planning and safe abortion services under the conditions of the COVID-19 pandemic in the Republic of Moldova

Accessibility of family planning and safe abortion services under the conditions of the COVID-19 pandemic in the Republic of Moldova

Tinjauan Yuridis mengenai Tindak Pidana Aborsi terhadap Korban Pemerkosaan sebagai Bentuk Perlindungan Hukum

The purpose of this paper is to explain how the role of the government is in providing legal protection for abortion victims who are victims of murders that have occurred in Indonesia. The most detrimental impact of having an alternative is an unwanted pregnancy in the victim. Pregnancy victims are very extreme in terms of ability to use their reproductive rights. The subsequent consequences of this pregnancy will include suffering on a physical, mental and social level. Victims who experience trauma due to closure and receive trauma from unwanted pregnancies so that victims have multiple traumas. This research serves to examine the legality of abortion for rape victims. This research technique uses library research (Library Research). Rape has a very significant impact on victims in terms of social, educational, psychological, and health. The government makes abortion regarding abortion regulated in the Health Act. However, the authority to access information related to safe abortion services is not realized, victims of homicide are still unable to access safe abortion services. So that many victims choose to have an abortion in an unsafe way, for example, such as taking drugs, massage.

Knowledge of Ghana Abortion Laws and Factors Hindering Access to Safe Abortion Services by Female Students at the University for Development Studies (UDS)

Young women in the universities have an independence streak and have no restraints from parents, or school authorities regarding their sex lives, and can have as much sex as desired. If they have little knowledge on how to prevent unwanted pregnancies, they can pick seed and conceive. Lack of support from partners and/or family and limited monetary support lead them to make wrong choices regarding the termination of an unwanted pregnancy. The aim of this study was to assess the knowledge and factors hindering access to safe abortion services among female students at the U.D.S. This was a descriptive cross-sectional study conducted at the U.D.S. 100 female students between the ages of 15 and 45 years were conveniently selected from a database of 187 female students. A questionnaire containing the relevant research questions related to the topic was designed using google forms, pre-tested on randomly selected 20 participants out of the total study population and subsequently self-administered to 100 female students through a web-based electronic platform. Data were analyzed using SPSS version 20.0. Age distribution of study participants: 15-20 Years, 18 (18%), 21-25 Years, 67 (67%), 26-30 years, 15 (15%). Knowledge of abortion laws in Ghana: 71 (71%) Yes, 29 (29%) No. Revision of the current abortion law in Ghana: 72 (72%) Yes, 28 (28%) No. Reasons for change in abortion Laws: Infringes on basic human rights of women 89 (89%), Contents are obsolete 11 (11%). Knowledge of safe abortion methods: 95 (95%) Yes, 5 (5%) No. Knowledge of safe abortion centers: 69 (69%) Yes, 31 (31%) No. Knowledge of qualified safe abortion service providers: Gynecologists 50 (50%), Midwives 28 (28%), Pharmacists 15 (15%), General Nurses 7 (7%). Factors hindering access to safe abortion services: Religious beliefs 50 (50%), Cost of services 30 (30%), Fear of stigmatization 22 (22%), Lack of knowledge about services 8 (8%). Most student participants were between the ages of 21 and 25 years. Majority of the students have knowledge about abortion laws in Ghana, the different methods of safe abortion, and the availability of safe abortion service centers and providers. Half of the students think religious beliefs interfere with their willingness to access safe abortion services and that the Gynecologist is usually the most qualified specialist to provide safe abortion services.

Exploring the reasons for unsafe abortion among women in the reproductive age group in western Ethiopia

BackgroundUnsafe abortion, even though it is preventable, remains a significant cause of mortality and morbidity among women in the developing world. It has always been a dilemma for researchers to explore the reasons for unsafe abortion in communities due to the sensitive nature of the subject. As a result, the aim of this study was to explore the reasons for unsafe abortion in women of reproductive age in western Ethiopia, 2022. MethodsA qualitative study with a purposive sampling technique was used to explore the reasons for unsafe abortion. The sample size was determined by the data theoretical saturation. Thematic data analysis was used to analyse the data, which was aided by Open Code 4.03 software. ResultsFive thematic categories were drawn from the collected data. The categories were: lack of knowledge of safe abortion policy and services; socioeconomic conditions; safe abortion as a real religious and cultural taboo; stigma of unplanned pregnancy; and a desire to pursue education. ConclusionThe obtained evidence in this study revealed that lack of knowledge, poor socioeconomic conditions, cultural and religious beliefs, stigma of unplanned pregnancy, and a desire to pursue education were quoted by participants as reasons to unsafe abortion practices. As a result, it is critical to improve family planning education, raise awareness about safe abortion services, and educate young women about the consequences of unsafe; abortion to reduce the rate of unwanted pregnancy and unsafe abortion-related complications.

Kekerasan Seksual: Berkelindan di Antara Norma Hukum dan Agama

Sexual violence experienced by women with a variety of experiences is at the risk of not being recognized by the public, even by law enforcement officials who are not conscious of a victim’s perspective. This shows that there is a ‘big’ problem related to the public’s perspective on legal norms which makes its implementation conflicting with the constitution which guarantees rights and access to justice for women as citizens. This problem is also supported by an interpretation of religion that is not in favor of victims of sexual violence. This research is carried out to ensure that women who became victims of rape have access to justice in safe abortion services guaranteed by the constitution and religion (Islam). This is the novelty of this research, which is expected to fill in the gaps in a number of previous studies. The research methodology uses a descriptive qualitative approach.

Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study

BackgroundBetween 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how to access safe abortion services. They often lack adequate insight to make informed decisions. The purpose of this study was to explore the empowered perspectives of women leaders in Rwanda about the recent policy change for safe abortion. The study identifies women leaders’ perceived barriers and their attitudes about resulting consequences toward safe abortion.MethodIn this qualitative study, seven focus group discussions and eight key informant interviews were performed in October 2019. A total of 51 women leaders participated, their age ranging from 38 to 60 years. Participants were drawn from three districts, namely Gasabo, Kicukiro, and Nyarugenge. For variability of data, participants came from parliament, government ministries, government parastatals, and civil society organizations. All interviews were conducted in Kinyarwanda and later translated into English. Data were analyzed using qualitative content analysis.ResultsThe emerging theme Strong barriers and numerous consequences of safe abortion illustrates how women leaders perceive barriers to safe abortion and its related consequences in Rwanda. The theme is divided into two categories: (1) Perceived barriers of safe abortion and (2) Consequences of providing safe abortion. The sub-categories for the first category are Reluctance to fully support safe abortion due to perceived unjustified abortions”, Abortion-related stigma, Abortion is against cultural and religious beliefs, Emotional attachment to the unborn and Lack of awareness of abortion. The sub-categories for the second category are Perceived physiological trauma, Cause for barrenness/infertility, Increase in services abuse by adolescents/women, Increase of workload for healthcare providers, “Increase in sexual activities and STIs, and Abortion-related physiological trauma.ConclusionThe subject of safe abortion evokes mixed reactions among participants, and is entangled with unsafe abortion in most cases. Participants stress that the word ‘abortion’ disturbs, regardless of whether it relates to being safe or unsafe. Participants believe the word ‘abortion’ outweighs the word ‘safe’. Societal expectations play a major role in the decision-making process of any adolescent or a family member faced with a pregnant adolescent regardless of the existing safe abortion law. Community mobilization and sensitization are crucial if safe abortion in accordance with abortion law is to be embraced. Messages that reinforce safe abortion as acceptable and address stigma, fears of trauma, and barrenness should be developed to educate adolescents, parents, and women leaders about safe abortion, to mitigate unsafe abortion-related complications.

Knowledge and attitude towards Ghana's abortion law: A cross-sectional study among female undergraduate students.

Ghana amended its abortion law to permit abortion under certain circumstances due to the impacts of unsafe abortion. Even though the abortion law in Ghana is liberal, most women do not utilize the services. Studies have shown that lack of knowledge and attitude towards abortion laws are the barriers deterring women from using safe abortion services. This study, therefore, assessed the knowledge and attitudes of future female health professionals towards Ghana's abortion law. This was an institutional-based cross-sectional study among 240 female students undertaking undergraduate courses at the Fred Newton Binka School of Public Health (FNBSPH), the University of Health and Allied Sciences (UHAS), Ghana. Knowledge was measured with 9 items using yes or no responses while Attitude was measured using a five-point Likert scale with 14 items. Factors associated with poor knowledge among the students were determined using logistic regression. All analyses were done using STATA version 16.0. Of the 240 participants, 24 (10%) reported ever being pregnant. Among these pregnancies, 20 (83.3%) ended in abortions, with 15 (75%) of them unsafely done. The majority (53.3%) of the students knew the conditions under which abortion is allowed in Ghana and most (61.7%) of them had positive attitudes towards the abortion legislation in the country. The year of study (aOR: 0.06; 95%CI: 0.01-0.23), residential status (aOR: 0.44; 95%CI: 0.20-0.74) and poor attitude towards the abortion law (Aor:0.46; 95% CI: 0.26-0.82) were associated with poor abortion law knowledge among the students. This study has demonstrated that knowledge and attitude towards Ghana's abortion legislation among the students was fairly good. Students' year of study, residential status and attitude towards the abortion law were also found associated with poor knowledge of Ghana's abortion law. Increasing young women's knowledge of the abortion law may lead to more favourable attitudes towards abortion, improving the utilization of safe and legal abortion services.

Knowledge and attitudes of deaf persons towards safe abortion services in Ghana.

Deafness refers to partial or total loss of hearing, which, if not appropriately accommodated, may interfere with day-to-day living experiences. Deaf people encountered challenges in their efforts to access essential services, such as health care. While some attention has been given to general access to reproductive health services, less research has focused on the experiences of deaf women and girls when accessing safe abortion services. With unsafe abortion being a major cause of maternal deaths among women in developing countries, this study attempted to explore the perception of deaf women and girls in Ghana towards safe abortion services. The main aim of this study was to understand the perception and awareness safe abortion services among deaf women and girls in Ghana. In doing this, the contributors towards unsafe abortion practices among deaf women and girls were gathered. Penchansky and Thomas' accessibility to health care theory availability, accessibility, accommodation/adequacy, affordability, and acceptability guides this study. A semi-structured interview guide based on components of the theory was used for data collection from 60 deaf persons. The components of the theory were used as a priori themes that guided the data analysis. The results showed challenges associated with the indicators of health access. For instance, in terms of availability, it was revealed that deaf women had little knowledge about existing laws on safe abortion in Ghana. In relation to acceptability, deaf women were highly opposed to abortion for cultural and religious reasons. However, there was consensus that safe abortion could be conducted under certain conditions. The results of the study have implications for policymaking aimed at attaining equitable access to reproductive health care for deaf women. The need for policymakers to expedite public education and incorporate the needs of deaf women in reproductive health policies, as well as other study implications, are discussed.

Policy change to improve access to safe abortion care in federal Nepal.

In Nepal's constitution, safe abortion care is recognized as an essential component of a comprehensive approach to fulfill individuals' sexual and reproductive health and rights. In the current context of transition to a three-level governance (federal, provincial, and local), there are opportunities to accelerate decentralization and devolution of decision-making power, increase access to and coverage of safe abortion services, and improve health outcomes. This article documents the processes and results of the policy change undertaken by the Ministry of Health and Population in collaboration with development partners to decentralize the approval process of safe abortion sites and providers with the objective to increase access to and coverage of safe abortion services. With the decentralization of certification, the approval process for safe abortion service sites and providers has become simpler, less time consuming, and less expensive by reducing cost of traveling to Kathmandu or approaching authorities at the federal level. This has resulted in expanding safe abortion services across the country including remote areas with marginalized populations. Evidence-based advocacy enabled policy change for decentralization of the approval process. Collaboration among stakeholders has been vital for implementing the policy change, including issuing directives from the federal to provincial levels and capacity strengthening of provincial level officials in understanding the requirements for approval of sites and providers.

Availability of Safe Second-Trimester Abortion Services in Health Facilities in Accra, Ghana.

We examined providers, methods employed, cost, and other determinants of availability of second-trimester abortion services in health facilities in Accra, Ghana in 2019 to inform policy and program decisions. A two-stage mixed quantitative and qualitative study designs were employed in the conduct of the study. The first stage was a short interaction of the mystery client with a clinical care provider to identify health facilities that provide second trimester induced abortion, the cost, and referral practices, where the facility did not have the service. The second stage was in-depth interviews of second-trimester abortion care providers and non-providers in various health facilities. For internal validity, it also explored the procedure cost, referral, and other practices at the health facilities included in the study, independent of what was captured in the mystery client survey. Second-trimester abortion services in Accra, Ghana are widely unavailable even in most facilities that provided abortion services. Referral policies and practices indicated by the service providers at various facility levels were inadequate. Criminalization of the procedure, social stigma, and fear of complications are the main factors that adversely influence the availability of second-trimester abortion in health facilities in Accra. Albeit increasing demand for second-trimester abortion in health facilities in Accra, services are not readily available due to the ambiguity of the law, its interpretation, and limited flow of accurate information on providers. Policies and programs that limit access to Second-trimester abortions in Ghana are amendable to ensure safe services.

Postabortion and safe abortion care coverage, capacity, and caseloads during the global gag rule policy period in Ethiopia and Uganda

BackgroundAbortion-related complications contribute to preventable maternal mortality, accounting for 9.8% of maternal deaths globally, and 15.6% in sub-Saharan Africa. High-quality postabortion care (PAC) can mitigate the negative health outcomes associated with unsafe abortion. While the expanded Global Gag Rule policy did not prohibit the provision of PAC, other research has suggested that over-implementation of the policy has resulted in impacts on these services. The purpose of this study was to assess health facilities’ capacity to provide PAC services in Uganda and PAC and safe abortion care (SAC) in Ethiopia during the time in which the policy was in effect.MethodsWe collected abortion care data between 2018 and 2020 from public health facilities in Ethiopia (N = 282) and Uganda (N = 223). We adapted a signal functions approach to create composite indicators of health facilities’ capacity to provide basic and comprehensive PAC and SAC and present descriptive statistics documenting the state of service provision both before and after the GGR went into effect. We also investigate trends in caseloads over the time-period.ResultsIn both countries, service coverage was high and improved over time, but facilities’ capacity to provide basic PAC services was low in Uganda (17.8% in 2019) and Ethiopia (15.0% in 2020). The number of PAC cases increased by 15.5% over time in Uganda and decreased by 7% in Ethiopia. Basic SAC capacity increased substantially in Ethiopia from 66.7 to 82.8% overall, due in part to an increase in the provision of medication abortion, and the number of safe abortions increased in Ethiopia by 9.7%.ConclusionsThe findings from this analysis suggest that public health systems in both Ethiopia and Uganda were able to maintain essential PAC/SAC services during the GGR period. In Ethiopia, there were improvements in the availability of safe abortion services and an overall improvement in the safety of abortion during this time-period. Despite loss of partnerships and potential disruptions in referral chains, lower-level facilities were able to expand their capacity to provide PAC services. However, PAC caseloads increased in Uganda which could indicate that, as hypothesized, abortion became more stigmatized, less accessible and less safe.

A STUDY OF TEENAGE PREGNANCY ITS RISK FACTORS AND COMPLICATIONS AT THE TERTIARY CARE CENTER

Background: Pregnancy in girls between 10 and 19 years is adolescent or teenage pregnancy. Teenage parenthood comes with dangers and realities that have been well-documented. Material &amp; Methods:This observational study was conducted at Government Medical College, AkolaMaharashtra. 80 teenage mothers admitted to the ward from October 2019 to May 2021 were included after permission from the Institutional Ethics Committee, and consent from the patients &amp; was evaluated regarding teenage pregnancy, its risk factors, and complications. SPSS version 2.0 was used for statistical analysis. Results: The majority of the patients 68.8% were in the age group of 18-19 years, the mean age of the patients was 17.75 ± 1.22 years. 26.2% of patients were booked, 73.8% had unbooked status. 58.8% had preterm delivery (≤37 weeks), and 41.2% had term delivery. The prevalence of anemia (&lt;10 gm %) was 63.8%. 38.8% of patients were delivered through Lower Segment Caesarean Section (LSCS) and vaginal delivery was performed in 61.2%. 63.8% of patients had anemia while 21.2% and 13.7% of patients developed Pregnancy induced hypertension (PIH) and postpartum hemorrhage (PPH) respectively. 7.5% and 6.2% of patients had antepartum hemorrhage (APH) &amp; intrauterine growth restriction (IUGR) respectively. It was observed that unbooked status, preterm delivery, anemia, PIH, IUGR, Low birth weight (LBW), and NICU admission were signicant risk factors for teenage pregnancy. Conclusion: Teenage pregnancies are associated with adverse obstetric and perinatal outcomes. Maternal age is an important feature, as several obstetric and perinatal complications are more frequent in teenage mothers than in other age groups. Improving the general health and nutrition of the girl child, increasing the age of marriage and subsequent childbearing, and access to safe abortion services along with adequate antenatal care reduce the incidence of adverse pregnancy outcomes.