Prevalence and determinants of terminated and unintended pregnancies among married women: analysis of pooled cross-sectional surveys in Nigeria

Abstract

BackgroundInduced pregnancy termination and unintended pregnancy are two commonly occurring phenomena in the discipline of women’s reproductive health. In the present study, we explored cross-sectional data pooled from three rounds of Nigeria Demographic and Health Survey (NDHS) to understand the trends of prevalence of pregnancy termination and unintended pregnancy as well as the interplay of various sociodemographic and economic factors whereby these health issues occur.MethodsStudy participants were 79 825 currently married women aged 15–49 years. Data were collected from NDHS conducted in 2003, 2008 and 2013. Outcome variables were self-reported history of pregnancy termination and unintended pregnancy for the last birth. Data were analysed using descriptive and multivariable logistic regression methods.ResultsMean (±SD) age of the respondents was 28.7 years (±9.6). The overall prevalence of pregnancy termination and unintended pregnancy were about 11%. Older women had increase in the odds of terminated pregnancies, compared with women aged 15–19 years, while the converse was true for unintended pregnancy in the adjusted model. Educated women had significant higher odds of terminated and unintended pregnancies compared with women with no formal education. Women with higher wealth index were more likely to have unintended and terminated pregnancies after adjusting for other covariates. Remarkably, women who had unintended pregnancy were 1.47 times as likely to have terminated pregnancy compared with those who had no unintended pregnancy (OR=1.47; 95% CI 1.30 to 1.65). Experience of intimate partner violence had significant association with terminated and unintended pregnancies.ConclusionThe findings of this study showed that unintended and terminated pregnancies remain part of the issues to be addressed if the goal of ensuring healthy lives and promoting the well-being for all at all ages must be met. Stakeholders in Nigerian healthcare system should protect the lives of women who are vulnerable to the fatal consequences of unsafe abortion, especially in cases of rape, sexual assault, incest and where continuing a pregnancy would endanger the lives of women.

Assessment of determinant factors of pregnancy termination among women of reproductive age group in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey

“…Further, the odds of pregnancy termination among women of the younger age group were very high compared to those who were 35 and older. The fi nding revealed that this was consistent with reports from several studies previously conducted to examine the prevalence of pregnancy termination [25].…”

“…The odd of pregnancy termination is higher for women without knowledge of contraceptive use. Studies have shown that knowledge of contraceptive knowledge had signifi cantly decreased the occurrence of unwanted pregnancies and abortion [25,26]. This is because poor utilization of contraceptive methods is the basis of unintended pregnancy.…”

“…Previous studies showed that pregnancy termination not only harm the women, but also adverse birth outcomes such as prematurity (preterm birth), low birth weight, placental complications and birth defects exist as a consequence of pregnancy termination [3,4]. Rates of abortion related maternal deaths declining by 42% for the last 25 per 100,000 abortions with the highest rate in Africa, 141 per 100,000 abortions [5,6]. About 9% of maternal deaths in Africa were due to unsafe abortion that resulted in the exclusive bleeding and infections [7].…”

Trends in and predictors of pregnancy termination among 15-24 yer old women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

“…However, it, is not void of limitations that could have potential implications for the ndings. One of the shortcomings is due to the cross-sectional study design which does not enable us to infer causal relationships between predictors and the outcome variable [13,58]. Another is that the NDHS depends on selfreported data collection, which can be subject to bias especially in a setting like Nigeria where abortion is legally restrictive; making pregnancy termination more likely to be under-reported.…”

“…While much research has been published reporting on young people's knowledge, attitudes, practices and prevalence of pregnancy termination in SSA especially in Nigeria [3,9,12,14], fewer studies have investigated factors in uencing termination. The prevalence of pregnancy termination is higher in women of older age [8,[15][16]; young age of sexual debut [17]; employed women [13], unintended pregnancy [8,16], forced or transactional sex [18], physical or sexual intimate partner violence [19,20], higher number of living children [18,21], and higher wealth index [13,22]. Being married [8,13,[22][23], having a secondary education [15,22,24], modern contraceptive use [23] and residing in rural areas have been associated with lower prevalence of induced abortion [13,15].…”