THE PREVALENCE OF ILLICIT ABORTION AMONG WOMEN OF CHILD BEARING AGE IN ABIA STATE UNIVERSITY TEACHING HOSPITAL

Abstract

This study examined the prevalence of illicit abortion among women of childbearing age at Abia State University Teaching Hospital and the factors influencing their decision to seek such services. A quantitative survey research design was adopted for this study. A structured questionnaire was designed and administered to a sample of 133 respondents, selected through a simple random sampling technique. The data were analyzed using frequency tables, simple percentages, means, standard deviations, and t-tests to test the hypotheses. The results revealed a high prevalence of illicit abortion among women of childbearing age in the hospital, with socio-demographic factors such as age, educational background, and marital status significantly influencing the decision to seek such services. It was found that women who underwent illicit abortions often experienced significant health complications, including infections, hemorrhage, and uterine perforation. The study further showed that lack of access to healthcare services and information contributed to the high prevalence of illicit abortion. The t-test results confirmed that there were significant relationships between socio-demographic factors and the prevalence of illicit abortion, as well as between women’s health complications and the choice of abortion method. In conclusion, the study highlighted the critical need for improved healthcare access, accurate reproductive health information, and comprehensive abortion care services in Abia State. Recommendations include enhancing public awareness on the risks of illicit abortion, improving access to safe and legal abortion services, and addressing socio-economic barriers to reproductive health. The study also recommended strengthening the legal framework surrounding abortion and implementing policies aimed at reducing the stigma associated with abortion. These findings underscore the importance of creating a more supportive environment for women’s reproductive health choices, thereby reducing the prevalence of illicit abortion and its associated complications.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Abortion, defined as the termination of a pregnancy before the fetus can live independently outside the womb, is a highly controversial subject worldwide. The issue of abortion intersects with a variety of factors, including moral beliefs, religious views, and political ideologies. As such, abortion remains highly restricted or illegal in many parts of the world, with severe consequences for women's health and autonomy. According to the World Health Organization (WHO), approximately 25 million unsafe abortions occur annually, contributing to a significant portion of maternal mortality and morbidity. This issue is particularly prominent in countries like Nigeria, where cultural, religious, and legal restrictions push women towards unsafe abortion practices, often resulting in severe health complications (Kasso et al., 2022).

In many societies, women are forced to resort to unsafe and clandestine methods of abortion due to restrictive laws, social stigma, and lack of access to safe healthcare services. The prevalence of unsafe abortion is especially high in countries where there is limited access to family planning services or where contraceptive use is stigmatized. A study by Ganatra et al. (2017) reveals the alarming number of unsafe abortions performed in regions with restrictive abortion laws, showing a significant disparity in health outcomes between countries with liberal abortion policies and those with more stringent regulations. This highlights the need for comprehensive reproductive health education and access to safe, legal abortion services to reduce the incidence of unsafe abortions and improve maternal health outcomes.

Abia State University Teaching Hospital (ABSUTH), located in Umuahia, the capital of Abia State, is an important healthcare institution in southeastern Nigeria. As a prominent medical center, ABSUTH provides a wide array of healthcare services to the surrounding population. Given its importance, the hospital serves as a critical point of access for women seeking medical assistance for complications arising from unsafe abortions. In recent years, ABSUTH has witnessed a steady rise in the number of patients presenting with complications from illicit abortion procedures, such as infections, hemorrhages, and long-term reproductive health issues (Say et al., 2022). This makes it an essential location for conducting research on the prevalence and consequences of illicit abortion practices among women of childbearing age.

The legal framework surrounding abortion in Nigeria is restrictive and varies by region. Abortion is only allowed under specific circumstances, including when the life of the mother is at risk, in cases of rape, or incest. However, despite these legal restrictions, many women still resort to illicit abortion methods. These women often face social stigma, lack of information about contraceptive methods, and limited access to legal and safe abortion procedures. As a result, they turn to unsafe methods, such as self-induced abortion through unregulated pills or traditional practices. According to Oye-Adeniran et al. (2024), these methods can lead to severe health complications, including infertility, hemorrhage, and death. The high prevalence of these unsafe abortion practices underscores the urgency of addressing the underlying factors that drive women to seek illicit abortion services.

In Nigeria, the availability of unregulated abortion pills and traditional methods of abortion has exacerbated the problem of unsafe abortion. Women often turn to these options due to a lack of awareness about the risks associated with unsafe abortion practices. This has led to a rise in the number of women experiencing complications as a result of these procedures. Studies, such as those conducted by Bankole (2023), show that the increasing availability of abortion pills and the lack of regulation in many parts of Nigeria have made it easier for women to access unsafe abortion methods, despite the legal restrictions. This highlights the need for better regulation and oversight of abortion medications and practices to prevent the dangers associated with unregulated procedures.

Research on abortion practices is crucial to understanding the extent of the problem and the underlying factors driving women to seek illicit abortion services. It is important to explore the social, cultural, and economic factors that contribute to the decision to undergo unsafe abortion, as well as the impact of these practices on women's health and well-being. Abiola et al. (2022) emphasize the importance of studying the knowledge, attitudes, and practices surrounding abortion to inform policies and interventions aimed at reducing the incidence of unsafe abortions. This research can provide valuable insights into how best to address the barriers to safe and legal abortion access in Nigeria, as well as identify strategies for improving reproductive health education and care for women in need.

A significant factor that contributes to the prevalence of unsafe abortion in Nigeria is the stigma surrounding unplanned pregnancies and abortion. Many women who find themselves in difficult situations, such as those facing financial constraints or social pressure, are often afraid to seek help due to the fear of judgment and legal repercussions. The social stigma associated with abortion in Nigerian society makes it difficult for women to access the support they need to make informed decisions about their reproductive health. One of the key barriers to safe abortion is the perception that abortion is morally wrong, which often leads to the criminalization of women who seek abortions and the healthcare providers who offer them. This stigma also extends to the lack of education about reproductive health, with many women not understanding their options or the risks involved in unsafe abortion practices (Silva et al., 2022).

The rising prevalence of illicit abortion practices is also linked to economic constraints, as many women in Nigeria, particularly those from low-income backgrounds, struggle to access safe and legal abortion services. Financial limitations often prevent women from seeking professional medical care, and as a result, they may resort to unsafe methods in an attempt to terminate unwanted pregnancies. This economic pressure is compounded by the lack of comprehensive family planning services, which could help prevent unplanned pregnancies in the first place. Henshaw (2022) suggests that improving access to family planning methods and addressing the economic factors that influence women's reproductive decisions can help reduce the prevalence of unsafe abortions and the associated health risks.

The need for research on the prevalence of illicit abortion among women of childbearing age in Nigeria is more urgent than ever, particularly in regions like Abia State, where the practice appears to be widespread. This study will aim to assess the factors influencing women's decisions to seek illicit abortion services and explore the potential consequences of such practices on their health and well-being. The findings from this research will provide valuable insights that can inform public health policies and interventions aimed at reducing unsafe abortion practices in Nigeria. It will also contribute to the ongoing efforts to improve reproductive health services and access to safe abortion procedures, ultimately ensuring that women can make informed and safe choices about their reproductive health.

1.2 Statement of the Problem

The problem of unsafe abortion is a critical public health issue, especially in countries with restrictive abortion laws like Nigeria. Despite the availability of laws that permit abortion only under specific circumstances, such as when the mother’s life is at risk, many women still resort to illicit and unsafe methods of abortion. This often results in serious health complications, including infections, hemorrhages, and long-term reproductive health issues (Henshaw, 2022). In Nigeria, the prevalence of unsafe abortion practices is exacerbated by several factors, including socio-cultural stigma, financial constraints, and limited access to safe, legal abortion services (Ganatra et al., 2017).

While several studies have investigated abortion practices in Nigeria, there remains a significant gap in research that specifically focuses on the prevalence and causes of illicit abortion among women of childbearing age within tertiary healthcare settings, such as the Abia State University Teaching Hospital (ABSUTH). Most existing studies on unsafe abortion in Nigeria have focused on general trends and statistics, without in-depth exploration of the factors influencing women’s decisions to resort to illicit methods (Oye-Adeniran et al., 2024). Research focusing on the local context of ABSUTH, a prominent healthcare institution in southeastern Nigeria, could provide crucial insights into the specific challenges faced by women in this region.

Furthermore, while studies such as those conducted by Silva et al. (2022) have identified the consequences of unsafe abortion on women’s health, they have not addressed the specific cultural, economic, and educational barriers that may drive women in Abia State to seek unsafe abortion services. In many cases, these women face societal pressure, lack of financial resources, and limited access to education on reproductive health and family planning methods, leading them to choose unsafe methods to terminate unwanted pregnancies (Say et al., 2022). The relationship between these factors and the prevalence of unsafe abortion in Abia State remains poorly understood, especially in the context of the university teaching hospital, where many women present with complications arising from these procedures.

Additionally, although some studies have examined the legal aspects of abortion in Nigeria, the role of law enforcement, healthcare providers, and policy makers in shaping women’s access to safe abortion services has not been adequately addressed in the context of Abia State (Bankole, 2023). There is a need for more localized research that examines how legal restrictions, combined with the social stigma surrounding abortion, contribute to the growing prevalence of unsafe abortion practices in this region.

This research aims to fill these gaps by exploring the prevalence and patterns of illicit abortion among women of childbearing age attending ABSUTH, investigating the factors that influence their decisions to seek illicit abortion services, and examining the broader societal, economic, and legal factors contributing to the problem.

1.3 Objective of the Study

The main objectives of this study are to:

1. Determine the prevalence of illicit abortion among women of childbearing age in Abia State University Teaching Hospital.
2. Identify the socio-demographic factors that influence women’s decision to seek illicit abortion services.
3. Examine the consequences and complications faced by women who have undergone illicit abortion procedures.

1.4 Research Questions

The study answered the following research questions:

1. What is the prevalence of illicit abortion among women of childbearing age at Abia State University Teaching Hospital?
2. What socio-demographic factors (such as age, marital status, educational background, and socioeconomic status) influence women’s decision to seek illicit abortion services?
3. What are the health complications faced by women who have undergone illicit abortions in Abia State University Teaching Hospital?

1.5 Research Hypotheses

The following hypotheses were tested in this study:

1. There is no significant relationship between socio-demographic factors (such as age, marital status, and educational background) and the prevalence of illicit abortion among women of childbearing age in Abia State University Teaching Hospital.
2. Women who undergo illicit abortions do not experience significant health complications compared to those who have safe and legal abortions.
3. The prevalence of illicit abortion among women of childbearing age in Abia State University Teaching Hospital is not affected by access to healthcare services and information.