Costs and consequences of abortions to women and their households: a cross-sectional study in Ouagadougou, Burkina Faso

Abstract

Little is known about the costs and consequences of abortions to women and their households. Our aim was to study both costs and consequences of induced and spontaneous abortions and complications. We carried out a cross-sectional study between February and September 2012 in Ouagadougou, the capital city of Burkina Faso. Quantitative data of 305 women whose pregnancy ended with either an induced or a spontaneous abortion were prospectively collected on sociodemographic, asset ownership, medical and health expenditures including pre-referral costs following the patient’s perspective. Descriptive analysis and regression analysis of costs were performed. We found that women with induced abortion were often single or never married, younger, more educated and had earlier pregnancies than women with spontaneous abortion. They also tended to be more often under parents’ guardianship compared with women with spontaneous abortion. Women with induced abortion paid much more money to obtain abortion and treatment of the resulting complications compared with women with spontaneous abortion: US$89 (44 252 CFA ie franc of the African Financial Community) vs US$56 (27 668 CFA). The results also suggested that payments associated with induced abortion were catastrophic as they consumed 15% of the gross domestic product per capita. Additionally, 11–16% of total households appeared to have resorted to coping strategies in order to face costs. Both induced and spontaneous abortions may incur high expenses with short-term economic repercussions on households’ poverty. Actions are needed in order to reduce the financial burden of abortion costs and promote an effective use of contraceptives.

Patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa: a systematic review

“…Out of pocket cost for normal delivery services was catastrophic for only one study from DR Congo [47], however, costs were catastrophic in eight studies out of the twelve [18,19,27,30,35,44,47,54] that reported delivery by the C-section. Out of pocket payments were also catastrophic in three out of six studies on the management of eclampsia [21,47,54], one out of four studies about abortion services [31], one out of three studies on the management of low birth weight babies [59] and four out of five studies on the management of hemorrhage [21,44,47,54]. None of the studies on PAC costs indicated that catastrophic health expenditures were incurred.…”

Factors Associated with Management Outcome of Incomplete Abortion in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia

“…Success of treatment was higher in surgical methods than medical one [ 5 ]. In contrast, a number of studies conducted explaining that surgical techniques were more risky than medical intervention methods [ 6 – 12 ].…”

Estimating abortion incidence and unintended pregnancy among adolescents in Zimbabwe, 2016: a cross-sectional study

“…18-20 46 47 Cost might also be a barrier since adolescents may have less access to financial resources needed to obtain an abortion or treatment for abortion complications, especially given the sustained economic crisis and cash shortages in Zimbabwe. 46 48 49 Other studies have found that the cost of obtaining PAC can be catastrophic to women and their families, 50 so a lack of control over household resources, such as by married adolescents, 49 may contribute to the longer delays to care experienced by married PAC patients. Macroeconomic conditions could also affect access to and quality of care, and the decades of economic decline and resource constraints in Zimbabwe are important to consider in future research.…”