Assessment of induced abortion practices in urban Haiti: a mixed-methods study

Berry-Bibee, Erin; Jean, C.J. St.; Telemaque, Y.; Nickerson, Nathan M; Jamieson, David; Lathrop, Eva

doi:10.1016/j.contraception.2014.05.025

Cited by 2 publications

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“…In Haiti, misoprostol can be purchased at pharmacies without a prescription, but mifepristone is not available, in particular during the time frame of the DHS survey. Women in Haiti often gather information on abortions from community sources, and thus it is possible that specific combinations of abortifacient drugs and plants differed between geographic regions [ 14 ]. The exact content of abortifacient injections is also unclear from the DHS data although quinine and vaccines have been reportedly used to induce abortions in other contexts [ 6 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in a recent quantitative analysis of abortion across 28 low and middle-income countries, Chae, et al reported that abortion rates in Haiti were higher among married women, wealthier women, women aged 20 to 29, and women living in urban areas [ 13 ]. Qualitative data on abortion in urban areas of Haiti suggested that misoprostol and herbs were widely recognized as abortifacients and women tended to use multiple agents in combination with misoprostol to terminate pregnancies [ 14 ]. Additionally, it was reported that stigma was a significant barrier to abortion care in Haiti [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative data on abortion in urban areas of Haiti suggested that misoprostol and herbs were widely recognized as abortifacients and women tended to use multiple agents in combination with misoprostol to terminate pregnancies [ 14 ]. Additionally, it was reported that stigma was a significant barrier to abortion care in Haiti [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Abortion care in Haiti: A secondary analysis of demographic and health data

2018

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BackgroundAbortion-related mortality accounts for 8% of all global maternal deaths and 97% of the estimated 25 million unsafe abortions performed each year occur in low- and middle-income countries. Haiti has the highest rate of maternal mortality in the western hemisphere and to further understand the circumstances of induced abortion in Haiti, the current work uses data from the 2012 Demographic and Health Survey (DHS) to describe the methods of induced abortion in Haiti between 2007–2012 and to identify potential factors associated with use of different abortion methods.MethodsThis is a secondary analysis of nationally representative cross-sectional data from the 2012 Haitian DHS, a two-stage cluster randomized household survey. Analysis included descriptive statistics on participant demographics, methods of abortion, and location of / assistant for the abortion. Multivariate regression was conducted to determine if demographic characteristics were associated with: 1) increased or decreased odds of having an abortion; or 2) increased or decreased odds of reporting an evidence based or non-evidence based method of abortion.ResultsAmong the 14,287 women of childbearing age who completed the 2012 Haiti DHS survey, 289 women reported having an induced abortion in the previous five years. Recommended methods, manual vacuum aspiration (MVA) or misoprostol alone, were used in 26.6% of the abortions (n = 77). Additionally, 13.8% (n = 40) of abortions used these recommended methods in combination with a non-evidenced based method such as injections, plants or tablets. A total of 92 women had a dilation and curettage (D&C) abortion, either alone (n = 77) or in combination with another method (n = 15) and over a quarter (n = 80) of reported abortions were conducted by non-evidence based methods (n = 80). A majority of abortions using a recommended method were assisted by a relative/friend (n = 28) or were unassisted (n = 34). Most abortions occurred in private homes (n = 174) with hospitals/clinics being the second most common location (n = 84). Women in the middle (OR = 3.3, 95% CI = 2.0–5.6) and highest (OR = 7.4, 95% CI = 4.4–12.3) wealth brackets were more likely to have had an abortion in comparison to women in the lowest wealth bracket. Women who had ever been in a marital union were more likely to have had an abortion than those who had not. The only demographic factor predictive of aborting using a recommended method was living in an urban area, with urban-dwelling women being less likely to use a recommended abortion method (OR = 0.4, 95% CI = 0.2–0.9) in comparison with women living in rural settings.ConclusionIn a nationally representative survey in Haiti, 2% of women of childbearing age reported having an abortion in the five years prior to the survey. A large proportion of these abortions were carried out using non-evidence based methods and over half occurred outside of the formal health care system. Understanding women’s attitudes, knowledge and barriers around abortion is paramount to improving knowledge ...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abortion care in Haiti: A secondary analysis of demographic and health data

2018

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“…Haitian women state that abortion stigma prevents access to care, and following abortion women often present with symptoms for more than a week before pursuing necessary postabortion care (Berry-Bibee et al, 2014). Generally, Haitian women do not have access to contraception, abortion is illegal, and women who seek an abortion endure a social stigma both culturally and religiously (Maternowska, 2006).…”

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confidence: 99%

“…International studies have revealed unsafe conditions for women seeking abortions, with many women acquiring severe infections postabortion and needing to go to tertiary care facilities when possible, potentially increasing women’s mortality (Berry-Bibee et al, 2014; Martin, 2013; Maternowska, 2006; Sundaram, Juarez, Bankole, & Singh, 2012). …”

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Women's and Healthcare Workers’ Beliefs and Experiences Surrounding Abortion: The Case of Haiti

Albuja

Cianelli

Anglade

et al. 2017

J of Nursing Scholarship

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Purpose Women in developing countries usually encounter serious inequities in terms of women’s health. To date, there is limited understanding of abortion from the perspective of Haitian women. As a limited-resource country, Haiti faces complex social issues and healthcare challenges. With abortion being illegal, many adult and teenage women seek clandestine abortions. The aim of this study was to explore and gain a greater understanding of women’s and healthcare workers’ beliefs and experiences about abortion in Haiti. Methods Descriptive qualitative design was used to elicit information for the study. Eight focus groups were conducted with Haitian women and healthcare workers in five communities in the south of Haiti: Les Cayes, Aquin, St. Louis du Sud, Cavaillon, Maniche, and Ile a Vache. Participants were purposively selected and consented to participate and to be tape recorded. Content analysis followed using the verbatim transcripts, with triangulation of four researchers; saturation was reached with this number of focus groups. Findings The transcripts revealed six main themes regarding beliefs and experiences about abortion in Haiti: cultural aspects, consumers, perils of care, and legal concerns. Both women and healthcare workers discussed the repercussions of illegal abortion and the role of the government and hospitals. Participants identified similar perils and complications of unsafe abortions, such as postpartum hemorrhage and infection. Conclusions Results showed an urgent need to create a public health response that addresses different dimensions of abortion by engaging women and healthcare providers in rapid and concrete actions that promote access and safe care of women. It is imperative to conduct more research related to abortion in order to examine other associated factors to better understand the links between abortion and sexual health disparities among Haitian women. These results highlight the need for a rapid response to the need of this vulnerable group, who are experiencing high rates of mortality. This can also serve as a directive to approach this issue in other developing countries in the Caribbean region, particularly from its clinical relevance. Clinical Relevance Unsafe abortions are prevalent in developing countries; yet limited research exists on the topic. It is paramount to gain an understanding of the women’s and healthcare workers’ beliefs and experiences surrounding abortion, in order to develop interventions that prevent abortion complications in Haitian women.

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Assessment of induced abortion practices in urban Haiti: a mixed-methods study

Cited by 2 publications

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Abortion care in Haiti: A secondary analysis of demographic and health data

Abortion care in Haiti: A secondary analysis of demographic and health data

Women's and Healthcare Workers’ Beliefs and Experiences Surrounding Abortion: The Case of Haiti

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