Incidence of induced abortion in southern Ghana

Context: In countries such as Ghana, where the law restricts elective induc ed abortion, data to quantify the incidence of abortion are scarce. Existin g data on induced abortions in Ghana come mainly from hospital records, whi ch are unreliable because record-keeping is poor and induced abortions ofte n are classified inaccurately. Methods: A multistage random sampling design was used to identify 18,301 wo men aged 15-49 from eight communities in four of the 10 regions in Ghana be tween January and March 1997 Of the identified women, 1,689 were pregnant. From March 1997 to March 1998, fieldworkers living in the pregnant women's communities monitored their health and pregnancy outcomes, including self-i nduced abortions. Results: During the study period, the rate of abortion in the study areas w as 17 induced abortions per 1,000 women of childbearing age. There were 19 abortions per 100 pregnancies (or 27 abortions for every 100 live births). The majority (60%) of women who had an abortion were younger than 30 and 36 % were nulliparous. Forty-five percent had obtained their abortions before the seventh week of gestation, and 90% had done so before the 10th week. On ly 12% of the women said they had obtained their abortion from a physician. Muslim women had decreased odds of obtaining an abortion. Women who lived in urban areas. who were educated or who had four or more children had incr eased odds of obtaining an abortion. Women who were self-employed had great er odds of obtaining an abortion than those who were employed by someone el se. Conclusion: Ghana's abortion law does nothing to prevent many induced abort ions from occurring. However, few Ghanaian women who seek abortions obtain them from physicians, and most appear to induce abortions themselves, often in collaboration with pharmacists.