Knowledge, attitude, practice, and determinants emergency contraceptive use among women seeking abortion services in Dire Dawa, Ethiopia.

BACKGROUND: Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. OBJECTIVES: To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. METHODS: A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant's knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. RESULT: Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR = 0.027, 95% CI (0.007, 0.105)]. CONCLUSION: The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. RECOMMENDATIONS: Health professions should give attention in increasing knowledge and uptake of Emergency Contraception.

Women's experiences with legal abortion in Mexico City: a qualitative study.

In April 2007, elective first-trimester abortion was legalized in Mexico City. As of June 2011, more than 60,000 women from Mexico City and other Mexican states have obtained legal abortions in the city's public hospitals and health centers, with private facilities providing additional abortion services. This study examines women's experiences of abortion services in one public and two private clinic settings in 2008. Twenty-five in-depth interviews were conducted: 15 with women who obtained abortions in a public health center and 10 who obtained the procedure at either of two private clinics. Participants were highly satisfied with services at both public and private sites, although some had to go to more than one site before receiving services. None expressed doubts about their decision to have an abortion, and they felt unanimously that they were treated with respect. Furthermore, participants were pleased with the counseling they received and most accepted a contraceptive method after the procedure.

Abortion in Latin America: changes in practice, growing conflict, and recent policy developments.

Latin America is undergoing profound social, economic, political, demographic, and epidemiologic change. Reproductive health indicators have generally improved over the past two decades, but most pregnancies are still unintended and more than 4 million are terminated annually. Clandestine abortions necessitated by restrictive legal and social structures cause more than 1,000 deaths and 500,000 hospitalizations per year, primarily among poor and marginalized women. Abortions are becoming safer and less frequent, however, as a consequence of increased modern contraceptive use, misoprostol adoption, emergency contraception availability, and postabortion care provision, notwithstanding many impediments to these changes. Advocacy and conflict over abortion have grown. The contested policy shifts include Mexico City's 2007 legalization of first-trimester abortion. Drawing on numerous sources of evidence, this article provides a regional analysis of the rapidly changing practice and context of abortion in Latin America, and examines emerging issues, legal and policy developments, and contrasting country situations.

Exploring contraceptive knowledge and use among women experiencing induced abortion in the Greater Accra Region, Ghana.

Using a qualitative research methodology, twenty-four semi-structured interviews were conducted with women with induced abortion experiences at Korle Bu and Tema Hospitals in the Greater Accra Region, Ghana. Results suggest that these women tended not to have knowledge of contraceptive methods prior to the abortion, while others were informed but failed to use for a variety of reasons ranging from rumours of side effects to personal negative experiences with modem contraceptive methods. A few women also stated contraceptive failure as a reason for their unintended pregnancies that were later aborted. Peer and reproductive health education must be reinforced in communities in the Greater Accra Region to curb adolescents engaging in early sex and should challenge the existing rumours associated with contraception in Ghana. In addition, family planning services in terms of appropriate methods with no side effects must be made available to women in the reproductive ages.

Attitudes and experiences of women admitted to hospital with abortion complications in Ghana.

Unsafe abortion is one of the major contributors to high levels of maternal mortality in Ghana, despite a relatively liberal legal environment. This paper presents findings from a semi-structured hospital-based survey of 131 Ghanaian women who had experienced unsafe abortion. The majority of respondents were young and single, with no children or just one child. Most had middle-school education or higher and were employed, as were their partners. While knowledge of family planning was high, knowledge of specific methods was barely moderate and only 17% respondents had ever used it - much lower than the national ever-use of 39%. There were widespread misunderstandings about who could use family planning and 41% said they were afraid of side-effects. Eleven percent said their pregnancy was planned and 31% that they wanted their pregnancy but were pressured by partners or families to abort. Overall, about one-third of respondents said they aborted because they were not married and two-thirds said they aborted because of socio-cultural pressures. This study highlights clear ongoing failings of the family planning programme which needs to be revamped, as well as an urgent need for improving public knowledge about access to safe, legal abortion services.

Preventing and terminating unwanted pregnancies in Turkey.

PURPOSE: To determine the methods used to prevent pregnancy by women seeking abortion of unwanted pregnancy, their knowledge and use of emergency contraception, and reasons for wanting the abortion. DESIGN: The sample was 144 randomly selected women, who requested abortion for termination of their pregnancies at two hospitals in Izmir, Turkey, during the study period. METHODS: A questionnaire was completed by the researcher in face-to-face interviews. FINDINGS: In this sample 43.8% had had previous abortions; 77.1% used some method of family planning; 7.0% used emergency contraceptives. The methods selected after unprotected sexual intercourse by these women included vaginal douche (37.5%), waiting to see whether the menstrual cycle would begin (27.0%), going to a hospital or maternal-child health center (24.3%), and two other alternatives (4.2%). One-fifth of the women said that, if they get pregnant again, they will have another abortion. CONCLUSIONS: The number of unwanted pregnancies is high and many women seek abortions as a birth control method. Women in this sample needed information about effective methods for preventing pregnancy.

Reports from the Faculty of Family Planning and Reproductive Health Care AGM, May 2002. Assessing the quality of information leaflets about abortion methods in England and Wales.

This study assessed the quality of written information about abortion methods provided by clinics in England and Wales. Forty-four sets of leaflets were collected. The average leaflet was found to provide only half the possible information about benefits, risks and general procedures. Only half of the leaflets were of standard readability and accessible by 83% of the British population. Therefore, it seems unlikely that most women in England and Wales are in a position to make an informed decision about abortion method.

Contraceptive usage among abortion seekers in Nigeria.

A study on contraceptive usage among abortion seekers in 150 randomly selected health institutions in the most and the least urbanized states of the health zone B representing the South Western states of Nigeria was conducted over a period of 2 months. There were 1839 abortion seekers during the period. About 30.4% (559) of the respondents admitted to ever used any form of contraceptive methods. Most of the respondents who admitted to ever used any form of contraceptives i.e. 81.2% (454/559) were not using the contraceptive methods regularly and this cut across all the methods. Oral contraceptive pill was the commonest method used, though not on regular basis. The most frequent reason for not ever used contraceptive methods was ignorance. There is a need for intensification of strategies for promotion of use of family planning methods, which can be achieved through good counselling, sexuality education, and availability of cheap, and affordable contraceptive methods and services.