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Liu J, Duan Z, Zhang H, Tang L, Pei K, Zhang WH. A global systematic review and meta-analysis of prevalence of repeat induced abortion and correlated risk factors. Women Health 2023:1-13. [DOI: 10.1080/03630242.2023.2195018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Studnicki J, Longbons T, Reardon DC, Fisher JW, Harrison DJ, Skop I, Cirucci CA, Craver C, Tsulukidze M, Ras Z. The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study. Health Serv Res Manag Epidemiol 2022; 9:23333928221130942. [PMID: 36246345 PMCID: PMC9554127 DOI: 10.1177/23333928221130942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Multiple abortions are consistently associated with adverse health consequences. Prior abortion is a known risk factor for another abortion. Objective To determine the persistence of the association of a first-pregnancy abortion with the likelihood of subsequent pregnancy outcomes. Methods Data was extracted for a study population of 5453 continuously eligible Medicaid beneficiaries in states which funded and reported elective abortions 1999-2015. Women age 16 in 1999 were organized into three cohorts based upon the first pregnancy outcome: abortion, birth, natural loss. Results Women in the abortion cohort are more likely than those in the birth cohort to experience another abortion rather than a birth or natural loss, and less likely to experience a live birth rather than an abortion or natural loss, for every subsequent pregnancy. The tendency toward abortion (OR 2.99, CL 2.02-4.43) and away from birth (OR 0.49, CL 0.39-0.63) peaks at the sixth pregnancy, but persists throughout the reproductive period ages 16-32. The pattern is reversed, but similarly consistent, for women in the birth cohort. They remain likelier to have another birth rather than an abortion or natural loss in subsequent pregnancies. Compared to the birth cohort, the abortion cohort had 1.35 times as many pregnancies: 4.31 times the abortions, 1.53 times the natural losses, but only 0.52 times the births. They were 4.3 and 5.0 times as likely to have 2-plus and 3-plus abortions, but only 0.47 times and 0.31 times as likely to have 2-plus and 3-plus births. Of the abortion cohort, 37.1% had no births. By contrast, 73.6% of the birth cohort had no abortions. Conclusion The first-pregnancy abortion maintains a strong and persistent association with the likelihood of another abortion in subsequent pregnancies, enabling a cascade of adverse events associated with multiple abortions.
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Affiliation(s)
- James Studnicki
- Charlotte Lozier Institute, Arlington, VA, USA,James Studnicki, Charlotte Lozier Institute, 2800 Shirlington Rd., Ste. 1200, Arlington, VA, 22206, USA.
| | | | | | | | - Donna J. Harrison
- American Association of Pro-Life Obstetricians and Gynecologists, Eau Claire, MI, USA
| | - Ingrid Skop
- Charlotte Lozier Institute, Arlington, VA, USA
| | | | | | - Maka Tsulukidze
- Department of Health Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Zbigniew Ras
- Computer Science Department, University of North Carolina at Charlotte, Charlotte, NC, USA
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Li C, Gao J, Liu J. Repeat abortion and associated factors among women seeking abortion services in northwestern China: a cross-sectional study. BMC Public Health 2021; 21:1626. [PMID: 34488713 PMCID: PMC8422724 DOI: 10.1186/s12889-021-11653-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Repeat abortion is a significant public health problem in China. International knowledge about repeat abortion and its associated factors in Chinese women is scarce. This study aimed to analyze the prevalence of repeat abortion among women seeking abortion services with unintended pregnancies in northwestern China and to identify factors associated with the repeat abortion from both two perspectives of abortion seekers themselves and their sexual partners. Methods This cross-sectional survey was conducted from May 1st to May 31st, 2020, in 90 medical institutions in Xi’an, the largest city in northwestern China. All women seeking abortions within the first 12 weeks of pregnancy were invited to participate in this survey; however, only those abortion seekers with unintended pregnancies were extracted and included in this study. Pearson’s chi-squared tests, Kolmogorov-Smirnov tests, and binary logistic regression analysis were performed. Results Of 3397 abortion seekers, 56.6% (1924) were undergoing repeat abortions. Participants who were older than 30 years (OR: 1.37, 95% CI: 1.08–1.73 for 31–35 years; 1.82, 1.29–2.57 for ≥36 years), received a low-level education (1.86, 1.42–2.43 for ≤senior high school; 1.46, 1.17–1.83 for junior college), were jobless (2.46, 1.18–5.13), had one child (1.54, 1.10–2.17), had a general (1.60, 1.28–1.98) or no (2.51, 2.02–3.11) cognition of possible adverse health effects of having abortions, and had used contraception at the time of conception, i.e., condoms (1.33, 1.09–1.61), withdrawal (1.43, 1.12–1.84), and emergency measures (1.48, 1.09–1.99) were more likely to undergo a repeat abortion. Besides, participants whose sexual partners were older than 30 years (1.33, 1.06–1.68 for 31–35 years; 2.13, 1.56–2.91 for ≥36 years), attained a low-level education (1.66, 1.28–2.15 for ≤senior high school; 1.38, 1.10–1.74 for junior college), received a high-level monthly income (1.34, 1.08–1.65 for ≥6001 Yuan), and had a weak or very weak willingness to use contraception (6.84, 2.42–19.33) were more likely to have a repeat abortion. Conclusions The study findings highlight the problem of repeat abortion in China and suggest the need for government and civil society to increase efforts to reduce the risks of unintended pregnancy and repeat abortion in China. One approach may be to offer better access to reproductive health and contraception knowledge to women and their sexual partners and to promote their correct, consistent, and effective contraception practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11653-4.
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Affiliation(s)
- Chen Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Jianmin Gao
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.,School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, 710129, Shaanxi, China.
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Liu J, Duan Z, Zhang H, Wen C, Tang L, Pei K, Zhang WH. Prevalence and risk factors for repeat induced abortion among Chinese women: a systematic review and meta-analysis. EUR J CONTRACEP REPR 2021; 26:513-522. [PMID: 34184608 DOI: 10.1080/13625187.2021.1944618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Repeat induced abortion is a significant public health problem in China. International knowledge about repeat induced abortion and its associated risk factors in Chinese women is scarce, and existing studies are hard to access for international scholars because most are published in Chinese. A systematic review was conducted to analyse the prevalence of repeat induced abortion among Chinese women and determine correlated risk factors. METHODS Seven electronic databases were systematically searched. Data on the prevalence of repeat induced abortion and related factors were extracted and pooled using a meta-analysis and narrative approach. RESULTS Of 2458 articles retrieved from seven databases, 21 were included in the study. The overall pooled prevalence of repeat induced abortion was 43.1% (95% confidence interval 36.7%, 49.5%). Of 25 exposures extracted, 15 factors were significantly correlated with repeat induced abortion, comprising seven individual demographic factors (i.e., age, education, employment, migrant status, parity, unhealthy lifestyle habits and region of residence), four reproductive health- and contraception-related factors (i.e., age at sexual debut, history of sexual activity, contraceptive knowledge and having a regular sexual life) and four sexual partner-related factors (i.e., multiple sexual partners, age of sexual partner, educational level of sexual partner and cohabitation with sexual partner). CONCLUSION The study findings highlight the problem of repeat induced abortion in China and suggest the need for government and civil society to increase efforts to reduce the alarming risks of repeat induced abortion in Chinese women and make them and their sexual partners more aware and protective of their sexual and reproductive health.
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Affiliation(s)
- Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, China
| | - Zhuqing Duan
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Hairui Zhang
- Institute for Research on Health Information and Technology, School of Public Health, Xi'an Medical University, Xi'an, China
| | - Chunmei Wen
- Department of Maternal and Child Health, Health Commission of the Shaanxi Province, Xi'an, China
| | - Longmei Tang
- School of Public Health, Hebei Medical University, Shijiazhuang, China.,International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Kaiyan Pei
- Social Medicine Center, National Research Institute for Family Planning, Beijing, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Repeat Induced Abortion among Chinese Women Seeking Abortion: Two Cross Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094446. [PMID: 33922140 PMCID: PMC8122746 DOI: 10.3390/ijerph18094446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/02/2021] [Indexed: 11/21/2022]
Abstract
Background: In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies. Methods: Two hospital-based cross-sectional surveys were conducted from 2005–2007 and 2013–2016 in 24 and 90 hospitals, respectively. The survey included women who sought an induced abortion within 12 weeks of pregnancy. The proportion of repeat induced abortions by adjusting the covariates through propensity score matching was compared between the two surveys, and the zero-inflated negative binomial regression model was established to identify independent factors of repeat induced abortion. Results: Adjusting the age, occupation, education, marital status and number of children, the proportion of repeat induced abortions in the second survey was found to be low (60.28% vs. 11.11%), however the unadjusted proportion was high in the second survey (44.97% vs. 51.54%). The risk of repeat induced abortion was higher among married women and women with children [ORadj and 95% CI: 0.31 (0.20, 0.49) and 0.08 (0.05, 0.13)]; the risk among service industry staff was higher when compared with unemployed women [ORadj and 95% CI: 0.19 (0.07, 0.54)]; women with a lower education level were at a higher risk of a repeat induced abortion (ORadj < 1). Compared with women under the age of 20, women in other higher age groups had a higher frequency of repeat induced abortions (IRadj: 1.78, 2.55, 3.27, 4.01, and 3.93, separately); the frequency of women with lower education levels was higher than those with a university or higher education level (IRadj > 1); the repeat induced abortion frequency of married women was 0.93 (0.90, 0.98) when compared to the frequency of unmarried women, while the frequency of women with children was 1.17 (1.10, 1.25) of childless women; the induced abortion frequency of working women was about 60–95% with that of unemployed women. Conclusions: The repeat induced abortion proportion was lower than 10 years ago. Induced abortion seekers who were married, aged 20 to 30 years and with a lower education level were more likely to repeat induced abortions.
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Bhowmik J, Biswas RK, Ananna N. Women's education and coverage of skilled birth attendance: An assessment of Sustainable Development Goal 3.1 in the South and Southeast Asian Region. PLoS One 2020; 15:e0231489. [PMID: 32315328 PMCID: PMC7173780 DOI: 10.1371/journal.pone.0231489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/24/2020] [Indexed: 11/30/2022] Open
Abstract
Objective The objective of Sustainable Development Goal 3.1 is to reduce the global maternal mortality ratio (MMR) below 70 per 100,000 live births by 2030. One of the indicators for this objective is the proportion of births attended by skilled health attendants (SBA). This study assessed the progress of low- and middle-income countries from South and Southeast Asian (SSEA) region in SBA coverage and evaluated the contribution of women’s education in this progression. Methods The Demographic and Health Surveys were assessed, which included 38 nationally representative surveys on women aged between 15-49 years from 10 selected SSEA region countries in past 30 years. Binary Logistic regression models were fitted adjusting the survey clusters, strata and sampling weights. Meta-analyses were conducted by collapsing effect sizes and confidence intervals of education modeled on SBA coverage. Results Results indicated that Cambodia, Indonesia and Philippines had over 80% SBA coverage after 2010, whereas Bangladesh and Afghanistan had around 50% coverage. Women with primary, secondary and higher level of education were 1.65, 2.21 and 3.14 times significantly more likely to access SBA care during childbirth respectively as compared to women with no education, suggesting that education is a key factor to address skilled delivery cares in the SSEA region. Conclusion Evaluation of the existing skilled birth attendance policies at the national level could provide useful insight for the decision makers to improve access to skilled care at birth by investing on women’s education in remote and rural areas.
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Affiliation(s)
- Jahar Bhowmik
- Department of Health Science and Biostatistics, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Raaj Kishore Biswas
- Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney, Australia
- * E-mail:
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Masanabo DKK, Govender I, Bongongo T. Reasons women terminate their pregnancies legally and their contraceptive practices at Soshanguve 3 Community Health Centre, Tshwane district, South Africa. S Afr Fam Pract (2004) 2020; 62:e1-e5. [PMID: 32242435 PMCID: PMC8378048 DOI: 10.4102/safp.v62i1.4310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/10/2020] [Accepted: 01/22/2020] [Indexed: 11/01/2022] Open
Abstract
Background: Various reasons have been cited in studies conducted in South Africa on why women legally terminate their pregnancies. We sought to determine the reasons for women to terminate their pregnancies legally and their contraceptive practices. This study was conducted at Soshanguve 3 Community Health Centre (CHC), located in a semi-rural zone in the north-west of Pretoria, Gauteng province of South Africa.Method: A cross-sectional study design was adopted in this study.Results: Of the 250 respondents, high participation (23.2%) was noted amongst women aged 18–20 years. Eighty-three (33.2%) respondents did not have children, 108 (43.2%) had completed their secondary school education and 226 (90.4%) were Christian. Of the participants, 80% were single and 62.8% were unemployed. About 85.6% (214) of respondents had not had a previous abortion. A total of 24% of respondents requested abortion because they wanted to focus on their education, while 23.1% were not ready to be parents and 21.7% experienced financial difficulties. With regard to practice, all respondents had already used contraception and the most used contraceptive was the male condom (43.5%), followed by an injectable contraceptive (7.1%).Conclusion: While academic reasons, not being ready to be a parent and financial difficulties were named as the main reasons for terminating a pregnancy legally, the selected pregnant women at Soshanguve 3 CHC demonstrated an unsatisfactory practice of contraceptive measures.
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Affiliation(s)
- David K K Masanabo
- Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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Waktola MI, Mekonen DG, Nigussie TS, Cherkose EA, Abate AT. Repeat induced abortion and associated factors among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017. BMC Res Notes 2020; 13:44. [PMID: 31992354 PMCID: PMC6988326 DOI: 10.1186/s13104-020-4904-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
Objective The aim of this study was to assess the proportion and determinants of repeat induced abortion among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017. Result From the total 567-sample size, 547 women were participated in the study making a response rate of 96.5%. In this study 191 women reported that they had at least one previous abortion, making the proportion of repeat induced abortion 34.9%. In multivariable logistic regression analysis; illiteracy (AOR = 8.45, 95% CI 1.85, 36.49), living in an urban area (AOR = 5.14, 95% CI 2.29, 11.53), having multiple sexual partner (AOR = 6.16, 95% CI 3.25, 11.68), consuming alcohol (AOR = 2.77, 95% CI 1.52, 5.05) and having a history of physical violence by a male partner (AOR = 2.68, 95% CI 1.45, 4.94) were significantly associated with repeat induced abortion at p value less than 0.05.
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Affiliation(s)
- Mahlet Imana Waktola
- College of Health, Department of Midwifery, Mizan Tepi University, Mizan Tepi, Ethiopia
| | - Dawit Gebeyehu Mekonen
- College of Medicine and Health Sciences, School of Midwifery, University of Gondar, Gondar, Ethiopia.
| | - Tewodros Seyoum Nigussie
- College of Medicine and Health Sciences, School of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Endeshaw Adimasu Cherkose
- College of Medicine and Health Sciences, School of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Addisu Taye Abate
- College of Medicine and Health Sciences, School of Nursing, Department of Medical Nursing, University of Gondar, Gondar, Ethiopia
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Bhowmik J, Biswas RK, Woldegiorgis M. Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014. Public Health 2019; 170:113-121. [PMID: 30991173 DOI: 10.1016/j.puhe.2019.02.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 02/11/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Antenatal care (ANC) during pregnancy and skilled birth attendance (SBA) during delivery are important policy concerns to reduce maternal deaths. Bangladesh is one of the developing countries which has made remarkable progress in both services during the last couple of decades by improving the SBA service rate from 16% in 2004 to 42.1% in 2014. However, this rate remains below the targeted level (50%) of the Health Population and Nutrition Sector Development Program set by the Ministry of the Health and Family Welfare of Bangladesh. This article explored the sociodemographic factors associated with the ANC and SBA service attainment. Furthermore, the possible implication of using ANC on SBA was also investigated. STUDY DESIGN The study followed a cross-sectional design using the Bangladesh demographic and health survey 2014, with a sample of size 4603 women with at least one live birth 3 years preceding the survey. METHODS Following a bivariate analysis, linear mixed-effect models were used to assess the relationship between sociodemographic factors and the outcome indicators (ANC and SBA). Finally, the association between SBA and ANC was evaluated through another mixed-effect model. RESULTS Wealth index, participation in household decisions, and partner's and respondent's education were significant predictors of ANC; whereas, residence, age at first birth, wealth index, working status, participation in household decisions, and partner and respondent's education were significant for SBA. Female education and household affordability were the strongest predictors for both ANC and SBA. ANC showed significant association with SBA as women accessing essential ANC during delivery seemed to be 4 times more likely (95% confidence interval: 3.05-5.93) to avail SBA services. CONCLUSIONS Overall, four factors were significant: residence, wealth index, education, and ANC access. Women residing in urban areas, having higher financial solvency, completing higher education, and accessing ANC by skilled personnel were more likely to receive SBA at delivery than their counterparts. Accessibility to skilled care during pregnancy leads to increased professional care during delivery. Thus, policies to encourage women and heads of families to seek skilled care during pregnancy would be beneficial to reach the maternal healthcare targets of Bangladesh.
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Affiliation(s)
- J Bhowmik
- Department of Statistics Data Science and Epidemiology, Swinburne University of Technology, Australia.
| | - R K Biswas
- Transport and Road Safety Research, University of New South Wales, Australia.
| | - M Woldegiorgis
- Department of Statistics Data Science and Epidemiology, Swinburne University of Technology, Australia.
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Liu J, Wu S, Xu J, Temmerman M, Zhang WH. Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050794. [PMID: 30841501 PMCID: PMC6427833 DOI: 10.3390/ijerph16050794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/25/2019] [Accepted: 02/27/2019] [Indexed: 11/16/2022]
Abstract
The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing repeat abortions. The primary reason for the current unintended pregnancies was non-use of contraception (68%). Adolescents receiving abortions who had an increased risk of repeat abortions were those who had children (OR 2.57, 95% CI 1.80⁻3.67), those who resided in a middle-developed region (OR 1.81, 95% CI 1.30⁻2.50), those who resided in a relatively poor region (OR 2.40, 95% CI 1.78⁻3.23), and those who had used contraception during the 6 months preceding the survey (OR 1.38, 95% CI 1.12⁻1.71 for condom use). The occupation as a student was a protective factor for adolescents (OR 0.64, 95% CI 0.50⁻0.83). Adolescents should be offered equal access to FP to that of married women in China to reduce unintended pregnancies and repeat abortions. Correct and consistent contraception practice should be promoted.
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Affiliation(s)
- Jinlin Liu
- Department of Public Health and Primary Care, International Centre for Reproductive Health (ICRH), Ghent University, 9000 Ghent, Belgium.
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Shangchun Wu
- The National Research Institute for Family Planning (NRIFP), Beijing 100081, China.
| | - Jialin Xu
- Chengde Nursing Vocational College, Chengde 067000, China.
| | - Marleen Temmerman
- Department of Public Health and Primary Care, International Centre for Reproductive Health (ICRH), Ghent University, 9000 Ghent, Belgium.
- The Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi 00100, Kenya.
| | - Wei-Hong Zhang
- Department of Public Health and Primary Care, International Centre for Reproductive Health (ICRH), Ghent University, 9000 Ghent, Belgium.
- Research Laboratory for Human Reproduction, Faculty of Medicine, School of Public Health Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium.
- Research Centre for Public Health, Tsinghua University, Beijing 100084, China.
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Steyn C, Govender I, Velaphi Ndimande J. An exploration of the reasons women give for choosing legal termination of pregnancy at Soshanguve Community Health Centre, Pretoria, South Africa. S Afr Fam Pract (2004) 2018. [DOI: 10.1080/20786190.2018.1432138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | - Indiran Govender
- Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University , Pretoria, South Africa
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Limoncin E, D'Alfonso A, Corallino C, Cofini V, Di Febbo G, Ciocca G, Mollaioli D, Patacchiola F, Jannini EA, Carta G. The effect of voluntary termination of pregnancy on female sexual and emotional well-being in different age groups. J Psychosom Obstet Gynaecol 2017. [PMID: 28635530 DOI: 10.1080/0167482x.2017.1285901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION To evaluate the impact of voluntary termination of pregnancy (VTOP) on the psycho-sexological well-being of females before/six months after the abortion. METHODS A sample of 194 women was recruited from three obstetrics and gynaecological divisions. The women were evaluated for the variables "sexual functioning" with the Female Sexual Function Index (FSFI), "depression" with the Beck Depression Inventory (BDI-II), and "anxiety state" with the Self-Rating Anxiety Scale (SAS) at time 0 (the beginning of the abortion procedure) and time 1 (six months after the abortion). Since 24 women refused to fill out the questionnaires, the final sample was composed of 170 women. RESULTS The women showed a slight although significant improvement in the mean FSFI score from time 0 (16.7 ± 12.9) to time 1 (20.9 ± 13.8) (p < 0.001) which paralleled with a slight decrease in the incidence of clinically significant sexual dysfunction [49% (84/170) (time 0) versus 34.1% (58/170) (time 1)], (McNemar's test; p = 0.0241). The sub-group of younger women (18-25) showed a lesser increase in FSFI score from time 0 to time 1. In addition, both depression (p = 0.048) and anxiety (p < 0.001) significantly decreased over time. However, the female sexuality remained impaired since more than two thirds (69.5%) of women were sexually dysfunctional six months after VTOP. DISCUSSION Voluntary TOP may influence the sexuality of younger females differently from how it influences that of older women. Hence, the sexuality of younger female should be regularly supervised in follow-up examinations.
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Affiliation(s)
- Erika Limoncin
- a Department of Clinical, Applied, and Biotechnological Sciences, School of Sexology , University of L'Aquila , L'Aquila , Italy
| | - Angela D'Alfonso
- b Gynecology and Obstetrics Division , S. Salvatore Hospital , L'Aquila , Italy
| | - Claudia Corallino
- a Department of Clinical, Applied, and Biotechnological Sciences, School of Sexology , University of L'Aquila , L'Aquila , Italy
| | - Vincenza Cofini
- c Department of Life, Health and Environmental Sciences , University of L'Aquila , L'Aquila , Italy
| | - Giovanna Di Febbo
- b Gynecology and Obstetrics Division , S. Salvatore Hospital , L'Aquila , Italy
| | - Giacomo Ciocca
- a Department of Clinical, Applied, and Biotechnological Sciences, School of Sexology , University of L'Aquila , L'Aquila , Italy
| | - Daniele Mollaioli
- a Department of Clinical, Applied, and Biotechnological Sciences, School of Sexology , University of L'Aquila , L'Aquila , Italy
| | - Felice Patacchiola
- b Gynecology and Obstetrics Division , S. Salvatore Hospital , L'Aquila , Italy
| | - Emmanuele A Jannini
- d Department of Systems Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Gaspare Carta
- b Gynecology and Obstetrics Division , S. Salvatore Hospital , L'Aquila , Italy
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Yaya S, Bishwajit G, Ekholuenetale M. Factors associated with the utilization of institutional delivery services in Bangladesh. PLoS One 2017; 12:e0171573. [PMID: 28192478 PMCID: PMC5305190 DOI: 10.1371/journal.pone.0171573] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 01/23/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. METHODS Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. RESULTS According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604), and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624), and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; p<0.001; 95%CI: 1.412-2.069). Wealth status was also a significant predictor of institutional delivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2.507; p<0.001; 95%CI: 2.118-2.968). In addition, results indicated that households of average economic class had a 27% higher level of institutional delivery service utilization compared to those of lower economic status (OR = 1.272; p = 0.011; 95%CI: 1.057-1.531). Furthermore, institutional health service use was 18% higher among participants who were aware of community clinical services compared to those who were hardly aware of these services (OR = 0.816; p = 0.012; 95%CI: 0.696-0.957). Lastly, the odds of utilizing delivery services was 1.553 times more likely for participants who use family planning compared to those who do not (p<0.001; 95%CI: 1.374-1.754), and 3.639 times more likely for those who receive antenatal care compared to those who do not (p<0.001; 95%CI: 3.074-4.308). These were found to be significant predictors of the choice of delivery services. DISCUSSION Our results suggest that efforts towards reducing national maternal mortality in Bangladesh could be aided by investments into education, poverty reduction and the strengthening of reproductive healthcare services through community clinics, with particular focus on rural areas.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Bishwajit G, Tang S, Yaya S, Ide S, Fu H, Wang M, He Z, Da F, Feng Z. Factors associated with male involvement in reproductive care in Bangladesh. BMC Public Health 2017; 17:3. [PMID: 28049458 PMCID: PMC5209938 DOI: 10.1186/s12889-016-3915-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Men’s active involvement in reproductive healthcare has shown to be positively associated with maternal and child health outcomes. Bangladesh has made appreciable progress in its pursuance of maternal mortality related goals in the framework of the MDGs. However, there remains a lot to be accomplished to realise the long-term goals for which active participation of male counterparts in reproductive care is crucial. Therefore, the objective of the present study was to investigate factors associated with male involvement in reproductive health among Bangladeshi men. Methods We used data from Bangladesh Demographic and Health Survey (BDHS) conducted in 2011. Study participants were 1196 married men, aged between 15 and 69 years and living in both urban and rural households. Level of male involvement (outcome variable) was measured based on the responses on knowledge, awareness and practice regarding reproductive health. Chi-square tests and multivariable logistic regression models were performed for data analysis. Results Out of 1196 participants, only 40% were found to be active about partners’ reproductive healthcare. Chi-square test showed significant association between active involvement and ever hearing about family planning (FP) in television, learning about FP through community health events, community health workers and poster/billboard. Results from logistic regression analysis revealed that type of residency [p = 0.004, AOR = 0.666, 95% CI = 0.504–0.879], literacy [secondary/higher education- p = 0.006. AOR = 0.579, 95% CI = 0.165–0.509], learning about family planning from Newspaper [p < 0.001. AOR = 1.952, 95% CI = 1.429–2.664], and television [p = 0.017. AOR = 1.514 95% CI = 1.298–1.886], and having been communicated about family planning by community health workers [p = 0.017. AOR = 1.946, 95% CI = 1.129–3.356] were significantly associated with active involvement of men in reproductive health issues. Conclusions Level of male involvement was associated with schooling experience, type of residency and exposure to electronic media. National health policy programs aimed at promoting male involvement in reproductive care should focus on improving knowledge and awareness of reproductive health though community health education programs with a special focus in the rural areas.
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Affiliation(s)
- Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, K1N 6 N5, Canada
| | - Seydou Ide
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6 N5, Canada
| | - Hang Fu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Manli Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhifei He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Feng Da
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Repeat induced abortions in Georgia, characteristics of women with multiple pregnancy terminations: secondary analysis of the Reproductive Health Survey 2010. Eur J Obstet Gynecol Reprod Biol 2016; 205:85-90. [DOI: 10.1016/j.ejogrb.2016.08.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/18/2016] [Accepted: 08/01/2016] [Indexed: 11/24/2022]
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