Disclosure, Contraceptive Practices, Reproductive Desires and Outcomes of Abortion, at Mbarara Regional Referral Hospital

Abstract

Background: Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion constitutes an important part of safe motherhood initiatives. Methods: This was a cross sectional study. The study period was from August to December 2015. Women with missed abortion and threatened abortion were excluded. The outcome variables included treatment outcomes, contraceptive practices, reproductive desires and disclosure. Results: There were a total of 40 respondents. Prevalence of knowledge of contraceptives was 87.5%, though 95% lacked knowledge of ECs.  The ended pregnancy was unintended in majority of respondents (62.5%). Half of the abortions 50% were induced. Of the eight induced abortions (62.5%) were done by health workers, (25%) by a traditional healer, and 12.5% by a relative. The methods used to induce the abortion included medical methods (25%) =5, surgical (60%) n=12, mechanical local (5%) n=1, herbal (10%) n=2.  Complications of abortion occurred in 20%. Women who had intended pregnancy were more willing to get more children as compared to women who had had unintended pregnancy, 60 % and 54 % respectively. More complications occurred among induced abortions as compared to spontaneous abortion37.5% and 9.7% respectively. Eight women (20%) volunteered to have induced abortion. Conclusion: There is low knowledge of ECs among women undergoing PAC at MRRH with majority having unintended pregnancy. Half of the abortions are induced. Providers of abortion include health workers, a traditional healer, and a relative. The methods used included medical method, mechanical local and, herbal   Complications of abortion occurred in 20%. , and these included septic abortion, perforated viscera and anaemia. Women who had intended pregnancy were more willing to get more children as compared to women who had had unintended pregnancy. More complications occurred among induced abortions as compared to spontaneous abortion. Voluntary disclosure was in 40% of all women who had induced abortion. Recommendations: There is need for expansion of contraceptive services in order to reduce the burden of unintended pregnancies. Emergency contraception should be made more available. All abortions should regard and managed as induced abortion as the rate of voluntary disclosure is low (40%).

Keywords: Contraceptive, Practice, Desires, Abortion.