Factors Associated with Repeat Induced Abortion in Kenya

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.

Table 3
Factors associated with repeat abortion; results from aged-standardized regression models
Variable	Odds ratio (OR)	Level of significance (p value)	95 % Confidence interval (CI)
Residence
Rural (ref.)	1.000
Urban	1.696	0.219	0.729–3.949
Marital status
Never married (ref.)	1.000
Married/Living together	1.748	0.123	0.858–3.559
Separated/Divorced/Widowed	6.804	0.000	2.778–16.663
Education
No education (ref.)	1.000
Primary	0.284	0.001	0.141–0.574
Secondary	0.336	0.010	0.148–0.765
Post-secondary	0.278	0.002	0.125–0.620
Previous live births
None (ref.)	1.000
1–2 births	2.104	0.012	1.182–3.745
3 or more births	2.503	0.086	0.878–7.134
Pregnancy wantedness
Wanted then (ref.)	1.000
Wanted later	0.347	0.025	0.138–0.874
Did not want	0.534	0.021	0.313–0.910
Unsure/don’t know	1.185	0.768	0.381–3.682
Gestation age
< =12 weeks (ref.)	1.000
> 12 weeks	0.885	0.623	0.543–1.442
Contraception a
Not using (ref.)	1.000
Short-acting method (SACM)	2.308	0.054	0.984–5.415
Long acting method (LACM)	1.068	0.934	0.223–5.123
Traditional method	9.474	0.004	2.043–43.934

Ref. reference category

Bold and italic p-values represent p < 0.05

a Short-acting methods include pills, injections, male and female condoms, diaphragm, foam/jelly patch and emergency contraception; Long-acting methods include implants, female and male sterilization and IUD; Traditional methods include rhythm, lactational amenorrhea, and withdrawal

Maina et al.

Maina et al. BMC Public Health 2015 15:1048   doi:10.1186/s12889-015-2400-3

Full article at: http://goo.gl/qZuOpc

By: Beatrice W. Maina^*, Michael M. Mutua and Estelle M. Sidze

Population Dynamics and Reproductive Health Program, African Population and Health Research Center (APHRC), Nairobi, Kenya

  

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