Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
Division of Nursing, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
PLoS One. 2024 Sep 5;19(9):e0309913. doi: 10.1371/journal.pone.0309913. eCollection 2024.
Pregnancy termination or induced abortion is not decriminalized, and access to safe abortion services is largely unavailable in Papua New Guinea (PNG). However, the practice is common throughout the country. This study aimed to estimate the prevalence and determine factors associated with pregnancy termination among married women aged 15-49 years in PNG.
Secondary data from the 2016-2018 PNG Demographic and Health Survey (PNGDHS) was used. A total weighted sample of 6,288 married women were included. The Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multivariable logistic regression were used to assess factors associated with pregnancy termination. Adjusted odds ratios (aORs) with 95% Confidence Intervals (CIs) were reported.
The prevalence of pregnancy termination was 5.3%. Nearly half (45.2%) of all pregnancy terminations occurred in the Highlands region. Women aged 35-44 years (aOR = 8.54; 95% CI: 1.61-45.26), not working (aOR = 6.17; 95% CI: 2.26-16.85), owned a mobile phone (aOR = 3.77; 95% CI: 1.60-8.84), and lived in urban areas (aOR = 5.66; 95% CI: 1.91-16.81) were more likely to terminate a pregnancy. Women who experienced intimate partner violence (IPV) were 2.27 times (aOR = 2.27; 95% CI: 1.17-4.41) more likely to terminate a pregnancy compared to those who did not experience IPV. Women with unplanned pregnancies were 6.23 times (aOR = 6.23; 95% CI: 2.61-14.87) more likely to terminate a pregnancy. Women who knew about modern contraceptive methods and made independent decisions for contraceptive use were 3.38 and 2.54 times (aOR = 3.38; 95% CI: 1.39-8.18 and aOR = 2.54; 95% CI: 1.18-5.45, respectively) more likely to terminate a pregnancy.
The findings highlight the role of sociodemographic and maternal factors in pregnancy termination among married women in PNG. Efforts aimed at reducing unplanned pregnancies and terminations should focus on comprehensive sexual and reproductive health education and improving easy access to contraceptives for married couples. Post-abortion care should also be integrated into the country's legal framework and added as an important component of existing sexual and reproductive health services.
在巴布亚新几内亚（PNG），终止妊娠或人工流产并未合法化，安全的堕胎服务也难以获得。然而，这种做法在全国范围内普遍存在。本研究旨在估计已婚 15-49 岁女性终止妊娠的流行率，并确定与终止妊娠相关的因素。
使用了 2016-2018 年巴布亚新几内亚人口与健康调查（PNGDHS）的二级数据。共纳入了 6288 名已婚女性的加权总样本。采用复杂样本分析方法来考虑研究的聚类设计和样本权重。卡方检验和多变量逻辑回归用于评估与终止妊娠相关的因素。报告了调整后的优势比（aOR）及其 95%置信区间（CI）。
终止妊娠的流行率为 5.3%。将近一半（45.2%）的所有妊娠终止发生在高地地区。35-44 岁的女性（aOR=8.54；95%CI：1.61-45.26）、不工作的女性（aOR=6.17；95%CI：2.26-16.85）、拥有移动电话的女性（aOR=3.77；95%CI：1.60-8.84）和居住在城市地区的女性（aOR=5.66；95%CI：1.91-16.81）更有可能终止妊娠。经历过亲密伴侣暴力（IPV）的女性（aOR=2.27；95%CI：1.17-4.41）比没有经历过 IPV 的女性更有可能终止妊娠。意外怀孕的女性（aOR=6.23；95%CI：2.61-14.87）比非意外怀孕的女性更有可能终止妊娠。了解现代避孕方法并独立决定使用避孕方法的女性（aOR=3.38；95%CI：1.39-8.18 和 aOR=2.54；95%CI：1.18-5.45）更有可能终止妊娠。
研究结果强调了社会人口学和产妇因素在 PNG 已婚女性终止妊娠中的作用。旨在减少意外怀孕和终止妊娠的努力应侧重于全面的性和生殖健康教育，并改善已婚夫妇获得避孕措施的机会。还应将堕胎后护理纳入国家法律框架，并将其作为现有性和生殖健康服务的一个重要组成部分。
