Abortion knowledge and experiences among young women and men in Accra, Ghana

Abstract

Background: Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods: To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher’s exact tests, and chi-square tests were performed. Results: Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women’s most recent abortions, medication abortion (61%), surgical methods (26%), and unsafe methods categorized “least safe” (14%) were the initial or only methods used. Most women who accessed medication abortion initially or as their only method saw a pharmacist (40%) or no one (33%). Nearly one-quarter of women (n=16, 24%) who initially took tablets used more than one method. Conclusions: Despite experiences with abortion, most young people in this study were unaware of its legality and unsafe abortions occurred. More needs to be done to ensure young people understand the law and have access to safe methods, and that pharmacists are trained to provide appropriate doses and formulations of medication abortion.

Determinants of Choice of Abortion Methods among Women in Ghana; Does Knowledge on legality of Abortion Matter?

“…33 The findings of this study further revealed that women in urban areas were less likely to engage in unsafe abortion methods compared to their rural counterparts. Similar results were found by earlier studies in Ghana 20 25 and Mozambique. 35 The possible explanation to this is the lack of access to safe abortion services among women in the rural areas.…”

“…This means the prevalence of unsafe abortions have doubled over the decade among women in Ghana. Similar findings were of high rate of abortion incidence were found by other studies recently in Ghana 20 25 , Ethiopia 49 and Nepal. 50…”

“…Knowledge and awareness on the law governing abortion practice can influence women with unplanned pregnancies to have access to safe abortion methods and use safe abortion methods. 25 51 In this study, respondents’ knowledge within the decade (2007-2017) on the legal status of abortion in Ghana have increased but this has not reflected in the reduction of the number of women who use unsafe abortion method as the proportion who used safe abortion methods have rather decreased. A study by Coast et al 16 provided some explanation to this phenomenon.…”

“…6 9 19 20 and unsafe abortion methods. 21-25 Other studies also examine the association between women’s knowledge of abortion law and the practice of induced abortion. 26-29 Further, while some studies use hospital-based data in examining this phenomenon 27 30-32 and community-based surveys 26 28 33 34 , others use nationally representative surveys.…”

“…26-29 Further, while some studies use hospital-based data in examining this phenomenon 27 30-32 and community-based surveys 26 28 33 34 , others use nationally representative surveys. 20 25 35 36 These previous studies did not fully explore and examine how demographic, socio-economic factors influence women’s knowledge on the legality of abortion under some conditions (rape, incest, risk to mothers and foetus health) and how that interaction determines their choice of abortion methods. Again, no study, to the best of my knowledge has examined how factors affecting the choice of abortion method and knowledge on legality of abortion change over time using nationally representative data.…”