Kabiru Caroline W, Ushie Boniface A, Mutua Michael M, Izugbara Chimaraoke O
African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.
John C Caldwell Population, Health and Development Visiting Fellow, the National Centre for Epidemiology & Population Health (NCEPH) and School of Demography, Australian National University, 9 Fellows Road, Acton, ACT, 2601, Australia.
BMC Pregnancy Childbirth. 2016 May 14;16:104. doi: 10.1186/s12884-016-0894-z.
Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya.
We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form.
Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %).
Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion care service providers must ensure that young clients receive contraceptive counseling and effective pregnancy prevention methods before discharge from the health care facility to prevent unintended pregnancies that may result in subsequent induced abortions.
在撒哈拉以南非洲地区，不安全堕胎是10至24岁年轻女性死亡的主要原因。尽管多次人工流产可能会增加健康状况不佳的风险，但对该地区有多次人工流产经历的年轻女性的研究极少。因此，本研究的目的是评估在肯尼亚寻求与堕胎相关护理的12至24岁年轻女性中，既往人工流产报告的患病率及其相关因素。
我们使用了2012年在全国范围内进行的一项调查中，246家医疗机构里1378名12至24岁寻求与堕胎相关护理的年轻女性的数据。在为期一个月的数据收集期间，使用堕胎病例采集表收集了这些女性的社会人口学特征、生殖和临床病史以及体格检查评估数据。
9%（n = 98）的年轻女性报告在此次接受护理的此次妊娠之前有过人工流产经历。在双变量水平上，根据既往人工流产史，在居住地区、宗教和职业方面观察到了具有统计学意义的差异。城市居民以及失业/其他年轻女性更有可能报告有过既往人工流产经历。与未报告有过既往人工流产经历的女性相比，报告有过既往人工流产经历的年轻女性中，有更大比例的人表示在此次妊娠时正在使用避孕方法（47%）。不出所料，与未报告有过既往人工流产经历的女性（64%）相比，报告有过既往人工流产经历的年轻女性中，有更大比例的人（82%）称此次妊娠是意外妊娠（完全不想要或时机不当）。
我们的研究结果表明，在肯尼亚寻求与堕胎相关护理的年轻女性中，约每十人中就有一人报告有过既往人工流产经历。需要针对年轻女性提供全面的堕胎后护理服务。特别是，堕胎后护理服务提供者必须确保年轻客户在从医疗机构出院前接受避孕咨询和有效的妊娠预防方法，以防止可能导致后续人工流产的意外妊娠。
