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Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys

Unsafe abortion is a major contributor to maternal morbidity and mortality. To gain insight into the ways in which abortion restrictions and stigma may shape reproductive health outcomes, we present self-reported data on abortions in Ethiopia and Uganda and compare these findings across the two vary...

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Autores principales: Giorgio, Margaret, Makumbi, Fredrick, Kibira, Simon Peter Sebina, Shiferaw, Solomon, Seme, Assefa, Bell, Suzanne O., Sully, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490852/
https://www.ncbi.nlm.nih.gov/pubmed/37682781
http://dx.doi.org/10.1371/journal.pgph.0002340
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author Giorgio, Margaret
Makumbi, Fredrick
Kibira, Simon Peter Sebina
Shiferaw, Solomon
Seme, Assefa
Bell, Suzanne O.
Sully, Elizabeth
author_facet Giorgio, Margaret
Makumbi, Fredrick
Kibira, Simon Peter Sebina
Shiferaw, Solomon
Seme, Assefa
Bell, Suzanne O.
Sully, Elizabeth
author_sort Giorgio, Margaret
collection PubMed
description Unsafe abortion is a major contributor to maternal morbidity and mortality. To gain insight into the ways in which abortion restrictions and stigma may shape reproductive health outcomes, we present self-reported data on abortions in Ethiopia and Uganda and compare these findings across the two varying legal contexts. W investigate differences in sociodemographic characteristics by whether or not a woman self-reported an abortion, and we describe the characteristics of women’s most recent self-reported abortion. In Ethiopia only, we classified abortions as being either safe, less safe, or least safe. Finally, we estimate minimum one-year induced abortion incidence rates using the Network Scale-Up Method (NSUM). We find that women who self-reported abortions were more commonly older, formerly married, or had any children compared to women who did not report an abortion. While three-quarters of women in both settings accessed their abortion in a health facility, women in Ethiopia more commonly used public facilities as compared to in Uganda (23.0% vs 12.6%). In Ethiopia, 62.4% of self-reported abortions were classified as safe, and treated complications were more commonly reported among least and less safe abortions compared to safe abortions (21.4% and 23.1% vs. 12.4%, respectively). Self-reported postabortion complications were more common in Uganda (37.2% vs 16.0%). The NSUM estimate for the minimum one-year abortion incidence rate was 4.7 per 1000 in Ethiopia (95% CI 3.9–5.6) and 19.4 per 1000 in Uganda (95% C 16.2–22.8). The frequency of abortions and low levels of contraception use at the time women became pregnant suggest a need for increased investments in family planning services in both settings. Further, it is likely that the broadly accessible nature of abortion in Ethiopia has made abortions safer and less likely to result in complications in Ethiopia as compared to Uganda.
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spelling pubmed-104908522023-09-09 Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys Giorgio, Margaret Makumbi, Fredrick Kibira, Simon Peter Sebina Shiferaw, Solomon Seme, Assefa Bell, Suzanne O. Sully, Elizabeth PLOS Glob Public Health Research Article Unsafe abortion is a major contributor to maternal morbidity and mortality. To gain insight into the ways in which abortion restrictions and stigma may shape reproductive health outcomes, we present self-reported data on abortions in Ethiopia and Uganda and compare these findings across the two varying legal contexts. W investigate differences in sociodemographic characteristics by whether or not a woman self-reported an abortion, and we describe the characteristics of women’s most recent self-reported abortion. In Ethiopia only, we classified abortions as being either safe, less safe, or least safe. Finally, we estimate minimum one-year induced abortion incidence rates using the Network Scale-Up Method (NSUM). We find that women who self-reported abortions were more commonly older, formerly married, or had any children compared to women who did not report an abortion. While three-quarters of women in both settings accessed their abortion in a health facility, women in Ethiopia more commonly used public facilities as compared to in Uganda (23.0% vs 12.6%). In Ethiopia, 62.4% of self-reported abortions were classified as safe, and treated complications were more commonly reported among least and less safe abortions compared to safe abortions (21.4% and 23.1% vs. 12.4%, respectively). Self-reported postabortion complications were more common in Uganda (37.2% vs 16.0%). The NSUM estimate for the minimum one-year abortion incidence rate was 4.7 per 1000 in Ethiopia (95% CI 3.9–5.6) and 19.4 per 1000 in Uganda (95% C 16.2–22.8). The frequency of abortions and low levels of contraception use at the time women became pregnant suggest a need for increased investments in family planning services in both settings. Further, it is likely that the broadly accessible nature of abortion in Ethiopia has made abortions safer and less likely to result in complications in Ethiopia as compared to Uganda. Public Library of Science 2023-09-08 /pmc/articles/PMC10490852/ /pubmed/37682781 http://dx.doi.org/10.1371/journal.pgph.0002340 Text en © 2023 Giorgio et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Giorgio, Margaret
Makumbi, Fredrick
Kibira, Simon Peter Sebina
Shiferaw, Solomon
Seme, Assefa
Bell, Suzanne O.
Sully, Elizabeth
Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title_full Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title_fullStr Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title_full_unstemmed Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title_short Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
title_sort self-reported abortion experiences in ethiopia and uganda, new evidence from cross-sectional community-based surveys
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490852/
https://www.ncbi.nlm.nih.gov/pubmed/37682781
http://dx.doi.org/10.1371/journal.pgph.0002340
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