Maina Beatrice W, Mutua Michael M, Sidze Estelle M
Population Dynamics and Reproductive Health Program, African Population and Health Research Center (APHRC), P.O. Box 10787-00100, Nairobi, Kenya.
BMC Public Health. 2015 Oct 12;15:1048. doi: 10.1186/s12889-015-2400-3.
Over six million induced abortions were reported in Africa in 2008 with over two million induced abortions occurring in Eastern Africa. Although a significant proportion of women in the region procure more than one abortion during their reproductive period, there is a dearth of research on factors associated with repeat abortion.
Data for this study come from the Magnitude and Incidence of Unsafe Abortion Study conducted by the African Population and Health Research Center in Kenya in 2012. The study used a nationally-representative sample of 350 facilities (level II to level VI) that offer post-abortion services for complications following induced and spontaneous abortions. A prospective morbidity survey tool was used by health providers in 328 facilities to collect information on socio-demographic charateristics, reproductive health history and contraceptive use at conception for all patients presenting for post-abortion services. Our analysis is based on data recorded on 769 women who were classified as having had an induced abortion.
About 16 % of women seeking post abortion services for an induced abortion reported to have had a previous induced abortion. Being separated or divorced or widowed, having no education, having unwanted pregnancy, having 1-2 prior births and using traditional methods of contraception were associated with a higher likelihood of a repeat induced abortion.
The findings point to the need to address the reasons why women with first time induced abortion do not have the necessary information to prevent unintended pregnancies and further induced abortions. Possible explanations linked to the quality of post-abortion family planning and coverage of long-acting methods should be explored.
2008年非洲报告的人工流产超过600万例,其中东非地区的人工流产超过200万例。尽管该地区相当一部分女性在生育期进行了不止一次人工流产,但关于重复流产相关因素的研究却很匮乏。
本研究的数据来自2012年非洲人口与健康研究中心在肯尼亚开展的不安全人工流产规模与发生率研究。该研究采用了全国代表性样本,选取了350家(二级至六级)提供人工流产和自然流产后并发症服务的机构。328家机构的医护人员使用前瞻性发病情况调查工具,收集所有前来接受人工流产后服务患者的社会人口学特征、生殖健康史以及受孕时的避孕措施使用情况等信息。我们的分析基于记录在案的769名被归类为进行过人工流产的女性的数据。
在寻求人工流产后服务的女性中,约16%报告曾有过人工流产史。分居、离婚或丧偶、未受过教育、意外怀孕、曾生育1 - 2次以及使用传统避孕方法与重复人工流产的可能性较高相关。
研究结果表明,有必要解决首次人工流产的女性为何没有预防意外怀孕和再次人工流产所需信息的问题。应探索与人工流产后计划生育质量和长效避孕方法覆盖率相关的可能解释。