Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

Abstract

Background Due to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the extent of induced abortions and occurrence of complications in Kinshasa. Methodology This cross-sectional study was conducted with a sample of 460 women who were interviewed about their experiences as females, and provided information of 1444 women of childbearing age living in Kinshasa. Respondents’ households were selected to represent the five types of residential quarters in Kinshasa, differentiated by cultural, socioeconomic, and infrastructural characteristics. Information was collected using a survey form and analyzed. Results Among all confidantes included in the study, 5.5% (95% CI: 4.4–6.8%) had induced abortions during 2015, a rate of 55.0 abortions per 1000 women of childbearing age. This practice was significantly performed amongst single/separated/divorced women; those without formal education, or primary-school education, and women who consumed excessive alcohol. Most abortions were induced by the administration of high doses of medication, by the women themselves or by health workers. A percentage of 51.9% (95%CI: 40.4–63.3%) of induced abortions led to complications, which were predominantly haemorrhagic. Moreover, 39% of patients had a complication for which they sought care, and of whom 12.5% had genital trauma or uterine perforation/intestinal necrosis. Conclusion Induced abortion is a public health problem in Kinshasa due to its frequency of practice, the complications that occur, and the absence of major surgeries in the health care package offered by the health centres or dispensaries that also provide the treatment of some serious complications. Thus, there is a need to focus on the enhancement of the health care package offered by health centres to include appropriate measures in favour of maternal health.

Factors associated with induced abortion among women of reproductive age attending selected health facilities in Addis Ababa, Ethiopia: a case control study

“…Yet, fear of school dropout was mentioned as a primary reason for demanding an induced abortion service among women of reproductive age in Ethiopia [ 20 , 28 ]. Similarly, studies conducted in low- and middle-income countries have consistently shown that unmarried women (single/separated/divorced/widowed) had higher odds of having an induced abortion compared with those who were married [ 15 , 29 , 30 ]. Other reasons could be difficulty in accessing contraception, not having adequate financial and social support to provide for their unborn child, and stigma related to having a child outside of wedlock have been indicated for higher odds of induced abortion among unmarried women [ 27 , 31 , 32 ].…”

Effects of implementing a postabortion care strategy in Kinshasa referral hospitals, Democratic Republic of the Congo

“…In the Democratic Republic of Congo (DRC), where legal advances in the practice of abortion are ignored by the population, and by a large majority of healthcare providers who remain committed to article 32 of the code of medical ethics which prohibits this practice unless its indication is the only way to save the life of the mother in danger, the rate of induced abortions is estimated at 55 per 1000 women of childbearing age in Kinshasa its capital [ 8 ]. Nearly half of these abortions are followed by complications that include hemorrhage, infection and traumatic injuries (genital trauma and uterine perforation).…”

“…Nearly half of these abortions are followed by complications that include hemorrhage, infection and traumatic injuries (genital trauma and uterine perforation). About 59% of women with a complication of induced abortion seek care in referral hospitals; the remainder seek care in lower level facilities, health centers and dispensaries [ 8 ]. Women admitted to referral hospitals for complications of induced abortions account for about 12.8% of all gynecological obstetrical emergencies.…”

Midwives’ integration of post abortion manual vacuum aspiration in the Democratic Republic of Congo: a mixed methods case study & positive deviance assessment

“…In the DRC, abortion is legally restricted. As a result, clandestine abortions are common and stigmatized [ 7 , 8 ]. Our team gave strict attention to maintaining local collaboration, which is crucial in building trusting relationships and facilitating trustworthiness, particularly when researching topics that intersect with abortion [ 48 ].…”

“…In 2016, 40,090 women and girls obtained post abortion care with 77% requiring treatment for complications in the capital city of Kinshasa alone [ 1 , 7 ]. Mortality rates for post abortion complications are as high as 37.8% (95% CI: 23.8–53.5%) [ 8 , 9 ] owing to critical gaps in community hospitals’ provision of basic delivery services and few referral services for post abortion care [ 6 , 7 , 10 , 11 ].…”