Magnitude and Determinants of the Late Request for Safe Abortion Care Among Women Seeking Abortion Care at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study

BACKGROUND: Second-trimester abortions disproportionately contribute to the increased medical cost, maternal morbidity, and mortality compared to the first trimester. Therefore, the aim of the current study was to determine the magnitude and determinants of late presentation for safe abortion care at a tertiary hospital in Ethiopia. METHODS: We conducted a cross-sectional study among pregnant women who requested safe abortion care from January 2019 to April 2020. Participants were selected using systematic sampling and data were collected using the interviewer-administered questionnaire. P-value adjusted odds ratios (AOR) with their 95% confidence interval (CI) were used to determine the association between variables. RESULTS: The prevalence of second-trimester abortion was 53.4%. Young age, ≤ 19 years (AOR= 6.37, 95% CI=1.84–22.06), decision ambivalence (AOR=5.64, 95% CI=1.71–18.61), delay to suspect pregnancy (AOR= 8.56, 95% CI=2.11–34.57), delay to diagnose pregnancy (AOR=3.83, 95% CI=1.51–9.75), lack of awareness on pregnancy signs and symptoms (AOR=4.22, 95% CI=1.59–11.23), delay to get the service (AOR =4.43, 95% CI=1.43–13.67), and lack of information where to get the abortion service (AOR=3.90, 95% CI=1.53–9.96) were significantly associated with presentation in second trimester. CONCLUSION: More than half of women who request safe abortion at Saint Paul’s Hospital Millennium Medical College do so in the second trimester. Young age, delay in diagnosis of pregnancy, delayed decision, and lack of information where to get service were contributing factors. Therefore, comprehensive adolescent sexuality education, increasing access to contraception, and safe abortion service including self-care interventions are very imperative to avert late gestation abortion and its consequences.