Knowledge, attitudes, and practice of abortion among women and doctors in Armenia

Abortion beyond a medical issue; women's perception on the current Ethiopian abortion law among reproductive-aged women by 2023, a community-based cross-sectional study

Background

A nationwide study on the contribution of abortion to maternal mortality in Ethiopia was 6%-9%. To bring Ethiopia's legal system into compliance with the country's new constitution, a new criminal code was created in 2005. In the new penal code, after 2005, abortion was permitted under broad circumstances; in the case of rape, incest, or fetal impairment; if pregnancy continuation or birth would endanger the health or life of the woman or fetus; if the woman has physical or mental disabilities; and if the woman is a minor who is physically or mentally unprepared for childbirth.

Objectives

To determine the status of women's perception toward the current Ethiopian abortion law among reproductive-aged women.

Method

A community-based study was conducted from June 10 to October 30, 2023. Chi-square test and multivariable logistic regression methods were employed using SPSS 23. The strength of associations and the significance level was examined using p-value and odds ratio at 95% CI, respectively.

Result

The prevalence of women's positive perception toward Ethiopian abortion law among reproductive-aged women is 21.18%. The age group of between 18 and 24, educational status of being unable to read and write, living solely, history of unplanned pregnancy, and age of marriage under 18 were associated with women's perception to the current abortion law of Ethiopia.

Conclusion

The finding of this study is unexpectedly low, which needs exhaustive intervention.

Legalisation of abortion in a poor-resource setting: nigerian undergraduates' perspectives

Background

Abortion is one of the leading causes of morbidity and mortality amongst Nigerian women in a country with restrictive abortion laws. Despite being illegal, abortions are still performed, and about 50% of abortions are performed by untrained persons in unhygienic conditions. This study assessed the determinants of attitude of undergraduates to legalisation of safe abortion in Nigeria.

Methods

It is a descriptive cross-sectional study. We used a three-stage sampling technique to select 423 undergraduates using a pre-tested questionnaire. The predictors of attitude towards abortion and its legalisation were identified during multivariate analysis.

Results

Good knowledge of abortion and its sequelae was found in about two-thirds (62.2%) of the participants, while over half (56.3%) had a negative perspective to abortion legalisation in Nigeria. Older participants were more likely to have positive perspectives to legalisation of abortion compared to their younger counterparts (odds ratio [OR] = 4.72, confidence interval [CI]: 2.61-8.55). Furthermore, respondents from upper social class and those with good knowledge were more likely to have positive perspectives to legalisation of abortion compared to their counterparts (OR = 5.63, CI: 3.12-10.16 and OR = 4.50, CI: 2.89-7.01).

Conclusion

The study showed that respondents' knowledge of abortion was relatively low amongst the study population, and more than half of the respondents did not want abortion to be legalised. Increasing awareness on the importance of abortion and its complications in Nigeria will curb the menace of death due to abortion now and in the future.

Quality of care in abortion in the era of technological and medical advancements and self-care

Background

Discussions around quality of abortion care have been focused mainly on service-delivery aspects inside healthcare facilities. More recently, with availability of medical abortion (MA), increase in its self-use, and emergence of other delivery platforms such as telemedicine, the responsibility of quality care has broadened to actors outside of facilities.

Body of text

This commentary discusses the meaning of quality of abortion care with the paradigm shift brought by medical and technological advancement in abortions, and raises questions on the role of the state in ensuring quality in abortion management—especially in settings where abortion is decriminalized, but also in countries where abortion is permitted under certain circumstances. It consolidates the experience gained thus far in the provision of safe abortion services and also serves as a forward-thinking tool to keep pace with the uptake of newer health technologies (e.g., availability of medical abortion drugs), service delivery platforms (e.g., telemedicine, online pharmacies), and abortion care providers (e.g., community based pharmacists).

Conclusions

This commentary provides context and rationale, and identifies areas for action that different stakeholders, including health advocates, policymakers, program managers, and women themselves, can adopt to fit into an alternative regime of abortion care.

Safe Abortion among Underprivileged Group Married Women of Low Resource Country: A Descriptive Cross-sectional Study

Introduction:

Unsafe Abortion is one of the leading causes of maternal death. The unhygienic and dangerous practice has been encountered in various geographical areas of Nepal. Despite its legalization, many women are still being not concerned and well informed regarding safe abortion and become victims of it. The main aim of this study was to assess the knowledge and practice regarding safe abortion among married women of reproductive (14 to 49) years of an underprivileged group of low resource country, Nepal.

Methods:

A descriptive cross-sectional study design was done in Rajbanshi community of Jhapa District. Data collection was done after taking ethical approval. Study population was selected conveniently. Data was collected by using a semi-structured questionnaire via face to face interviews among 420 married women of reproductive (14-49) years. All the extracted data were entered and analyzed using Statistical Package for the Social Services version 20. Descriptive analysis was done and presented using frequency and percentage.

Results:

Out of 420 respondents, 388 respondents (92.4%) found to have poor knowledge, regarding safe abortion. Likewise, only 44 respondents (10.05%) had practiced abortion, of which only 2 respondents (0.05%) had an unsafe abortion and 42 respondents (10%) had practiced safe abortion.

Conclusions:

Practices of unsafe abortion were prevalent. Respondents with poor knowledge were found to have done abortion. In this context, it can be concluded that knowledge regarding safe abortion can be increased by educating and providing awareness to the people of society.

Knowledge and attitude of women towards the legalization of abortion in the selected town of Ethiopia: a cross sectional study

Background

Unsafe abortion contributes to maternal deaths 13% globally and 25–35% of Ethiopia. By considering the problem of unsafe abortion, Ethiopia amended a law that permits abortion under certain circumstances. However, the country liberalized the service, women are still not using it. Therefore, the possible reason might be a lack of knowledge and attitude is a barrier that hinders women to use safe abortion.

Methods

A community-based cross-sectional study was conducted in Arba Minch town from January 02 to 17, 2017. Women in the reproductive age groups (15–49) who reside in the town for more than six months were included in the study. The sample size was determined using a single population proportion formula. Five kebeles were selected using the lottery method from 11 kebeles. The proportional allocation of the sample was done for each kebeles. Data were collected using a structured questionnaire. Binary and multiple logistic analyses were carried out to identify factors associated with knowledge & attitude toward legalization of abortion.

Result

A total of 576 women were responded to the question. The finding of our study showed that only 23.4% of women have knowledge about the legalization of abortion. Of all the respondents 323(56%) prefer abortion on demand to be legalized while about 241 (41.9%) do not prefer to be legalized. Again about 57% of women believe that women can use it but the rest 43% believe even if allowed women do not use it. From all participants, 59% don’t want to use by themselves and also, 53.3% don’t think that women would have the right to use the service or terminate their pregnancy even if the pregnancy fulfill the criteria. Ethnicity, marital status, and family size were the factors significantly associated with knowledge. Again, educational status, marital status and having knowledge about the legalization of abortion were a statistically significant association with the attitude.

Conclusion

The study indicated that knowledge of women toward the legalization of abortion was low but more than half of respondents prefer abortion on demand to be legalized.

Women's Awareness and Knowledge of Abortion Laws: A Systematic Review

Background

Incorrect knowledge of laws may affect how women enter the health system or seek services, and it likely contributes to the disconnect between official laws and practical applications of the laws that influence women’s access to safe, legal abortion services.

Objective

To provide a synthesis of evidence of women’s awareness and knowledge of the legal status of abortion in their country, and the accuracy of women’s knowledge on specific legal grounds and restrictions outlined in a country’s abortion law.

Methods

A systematic search was carried for articles published between 1980–2015. Quantitative, mixed-method data collection, and objectives related to women’s awareness or knowledge of the abortion law was included. Full texts were assessed, and data extraction done by a single reviewer. Final inclusion for analysis was assessed by two reviewers. The results were synthesised into tables, using narrative synthesis.

Results

Of the original 3,126 articles, and 16 hand searched citations, 24 studies were included for analysis. Women’s correct general awareness and knowledge of the legal status was less than 50% in nine studies. In six studies, knowledge of legalization/liberalisation ranged between 32.3% - 68.2%. Correct knowledge of abortion on the grounds of rape ranged from 12.8% – 98%, while in the case of incest, ranged from 9.8% - 64.5%. Abortion on the grounds of fetal impairment and gestational limits, varied widely from 7% - 94% and 0% - 89.5% respectively.

Conclusion

This systematic review synthesizes literature on women’s awareness and knowledge of the abortion law in their own context. The findings show that correct general awareness and knowledge of the abortion law and legal grounds and restrictions amongst women was limited, even in countries where the laws were liberal. Thus, interventions to disseminate accurate information on the legal context are necessary.

Medical abortion service in rural areas of Henan Province, China: a provider survey

AIM

The aim of this study was to explore the knowledge, attitudes and practices on medical abortion of abortion service providers in rural areas of China.

MATERIAL AND METHODS

A cross-sectional study via self-administered questionnaire was conducted among 362 abortion service providers from family planning service centers (FPSC) and hospitals in rural areas of Henan Province, China, between November 2009 and May 2010.

RESULTS

Most of the providers were female (99.4%) and obstetricians/gynecologists (63.3%). The knowledge score achieved ranged from 9.4 to 78.1 points, with both the median and the mode of 56.3 points. Of the 52.2% (189/362) of providers having a preference on abortion method, 30.2% (57/189) preferred medical abortion, while 69.8% (132/189) preferred surgical abortion. In total, 50.7% (174/343) of the providers indicated the provision of medical abortion should be expanded, with the three biggest challenges in its further expansion being increased complications/failures, poor client knowledge/awareness, and problems with drug/equipment supplies. Of all the providers, 81.7% and 92.2% reported they had experience in providing medical abortion and surgical abortion, respectively. Medical abortion providers were mainly experienced in misoprostol with oral (81.8%)/vaginal (79.6%) prostaglandin (misoprostol/gemeprost).

CONCLUSION

Knowledge on medical abortion of providers working in rural China was at a moderate level. Providers preferred surgical abortion to medical abortion. Providers have more experience in providing surgical abortion than medical abortion. Efforts should be made to overcome the perceived challenges in future expansion of medical abortion.