Centre for International Health and Development, Institute of Child Health, and University College London, UK.
J Womens Health (Larchmt). 2009 Dec;18(12):2017-22. doi: 10.1089/jwh.2008.1123.
This qualitative study explores the context of unsafe abortion in rural Ghana with the aim of identifying areas that should be considered when operationalizing abortion-related reproductive health strategies.
Data come from eleven narratives about planned or attempted abortions and seven narratives of abortion-related deaths. These individual data are supplemented by data from ten focus group discussions.
Communities describe abortions as dangerous and, if they become public knowledge, shameful. Despite this, abortions were understood as necessary for some women in some situations, but secrecy was paramount. Women carefully chose their confidants based on the anticipated reaction and did so for advice about cheap and effective methods or for financial assistance. Complications were usually managed at home. When complications were taken to the health facility, the abortion was often not disclosed. Women reported trying sequential abortion methods, starting with cheaper milder methods and, if these attempts failed, resorting to harsher more expensive methods. Access to pharmaceuticals and finances also determined the method used. Financial hardship, interruption of education, and being unmarried were the most frequently cited reasons for abortions.
Unsafe abortion is an important public health issue in Ghana. Current strategies to reduce abortion-related deaths include increasing the provision of safe abortion services. For the strategy to be successful, services should be accessible, affordable, and confidential, and discourse with communities and health workers to break the public silence about abortion is needed.
本定性研究旨在探讨加纳农村地区不安全堕胎的背景，以确定在实施与堕胎相关的生殖健康策略时应考虑的领域。
数据来自 11 个关于计划或尝试堕胎的叙述和 7 个与堕胎相关的死亡叙述。这些个人数据由来自 10 个焦点小组讨论的数据补充。
社区将堕胎描述为危险的，如果堕胎公开，会感到羞耻。尽管如此，一些妇女在某些情况下认为堕胎是必要的，但保密性至关重要。妇女根据预期的反应仔细选择她们的知己，并向他们寻求有关廉价有效方法或财务援助的建议。并发症通常在家中处理。当并发症被带到医疗机构时，通常不会披露堕胎。妇女报告说尝试了连续的堕胎方法，从更便宜、温和的方法开始，如果这些尝试失败，就会采用更严厉、更昂贵的方法。获取药品和资金也决定了使用的方法。经济困难、中断学业和未婚是堕胎最常提到的原因。
不安全堕胎是加纳的一个重要公共卫生问题。目前减少堕胎相关死亡的策略包括增加安全堕胎服务的提供。为了使该策略取得成功，服务应该是可及、负担得起和保密的，并且需要与社区和卫生工作者进行对话，打破公众对堕胎的沉默。
