Goemans Sophie, Singh Abhishek, Yadav Ajit Kumar, McDougal Lotus, Raj Anita, Averbach Sarah H
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA.
Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India.
Int J Womens Health. 2023 Sep 28;15:1467-1473. doi: 10.2147/IJWH.S414599. eCollection 2023.
To examine the association between self-managed abortion and the self-reported experience of abortion complications in India, a country with a high incidence of self-managed abortion.
The study used a cross-sectional multivariable logistic regression analysis of data from the National Family Health Survey (NFHS-4) of 2015-2016 to compare the odds of self-reported complications experienced during abortion between self-managed and clinician-managed abortions in India.
On average, self-managed abortions occurred earlier in gestation than clinician-managed abortions, 7.8 weeks and 11.3 weeks, respectively (p < 0.001). Self-managed abortion was associated with fewer self-reported abortion-related complications than clinician-managed abortions when adjusted for covariates not including gestational age (Adjusted Odds Ratio (aOR) 0.82, 95% confidence interval (CI) 0.69, 0.97). However, once adjusted for gestational age, there was no longer a clinically meaningful or statistically significant difference in the odds of self-reported complications between self-managed and clinician-managed abortions (aOR = 0.98, 95% CI 0.81, 1.18).
These findings suggest that people in India are using safe methods to self-manage abortions and support the hypothesis that self-managed abortion can improve access to abortion and reproductive choice without increasing risk.
在自行管理堕胎发生率较高的印度，研究自行管理堕胎与自我报告的堕胎并发症经历之间的关联。
本研究对2015 - 2016年全国家庭健康调查（NFHS - 4）的数据进行横断面多变量逻辑回归分析，以比较印度自行管理堕胎和临床医生管理堕胎中自我报告的堕胎期间并发症发生几率。
平均而言，自行管理堕胎发生时的孕周比临床医生管理堕胎更早，分别为7.8周和11.3周（p < 0.001）。在不包括孕周的协变量调整后，自行管理堕胎与临床医生管理堕胎相比，自我报告的与堕胎相关的并发症更少（调整优势比（aOR）为0.82，95%置信区间（CI）为0.69，0.97）。然而，一旦调整孕周，自行管理堕胎和临床医生管理堕胎在自我报告并发症几率方面不再存在具有临床意义或统计学意义的差异（aOR = 0.98，95% CI为0.81，1.18）。
这些发现表明，印度民众正在使用安全方法自行管理堕胎，并支持以下假设，即自行管理堕胎可以在不增加风险的情况下改善堕胎可及性和生殖选择。
