Abortions in a Hospital Setting: Hidden Realities in Dar es Salaam, Tanzania

Abstract

This study investigates the extent of unwanted pregnancy, the use of illegally induced abortion, and the attitudes toward and practice of contraception among women admitted to a hospital with the diagnosis of abortion in Dar es Salaam, Tanzania. (In Tanzania, induced abortion is permitted only to save the mother's life.) A random sample of 300 women with early pregnancy loss admitted to Muhimbili Medical Centre, the teaching hospital in Dar es Salaam, were interviewed between September and November 1987, using a structured questionnaire. Among the 300 respondents, 155 said that their pregnancy had been unwanted: 94 of them presented with an illegally induced abortion and 61 with a spontaneous abortion. The number of spontaneous abortions of unwanted pregnancies increased with age and stability in a relationship. Having a small child to look after and having completed the family were the most common reasons for the pregnancy to be unwanted in this group. Induced abortion was more a problem of the young, unmarried woman. The 61 women with spontaneous abortion but unwanted pregnancy suggest that a much larger group of pregnant women continue to term with what are, at least initially, unwanted pregnancies--precisely the group of women family planning programs want to reach. The low prevalence of contraceptive use in this group indicates the failure of family planning clinics to motivate their target group. Recommendations are made for improved functioning of family planning clinics.

Post Abortion Care Quality Status in Health Facilities of Guraghe Zone, Ethiopia

“…Even more disconcerting was that after a pregnancy loss, women were not given family planning information or supplies to space their next pregnancy [9]. Restrictive national laws, lack of access to safe abortion and lack of quality post-abortion car have led to the premature death of millions of mothers [10,11].…”

Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania

“…In settings where access to abortion is highly restricted and desire to regulate fertility is low, deaths due to abortion is a major contributor to maternal mortality [3]. In Tanzania, the law on abortion is highly restrictive and does not permit termination of pregnancy except when it is needed to save the life of a woman [4]. Consequently, women frequently resort to clandestine abortion performed by unskilled practitioners, leading to high rates of maternal mortality and morbidity.…”

Self-reports of induced abortion: an empathetic setting can improve the quality of data

“…The magnitude of the problem of unsafe abortion at the community level in Tanzania is unknown, but hospitalbased studies on the incidence of complicated, incomplete abortions indicate that such terminations are common. 6 It has been estimated that unsafe abortion is a contributory factor in 15% of maternal deaths in Dar es Salaam. 5 Studies in sub-Saharan Africa have shown that women who have undergone illegal abortion are reluctant or unwilling to discuss their experiences for fear of negative personal, social, legal, and even medical consequences.…”