Email updates

Keep up to date with the latest news and content from BMC Women's Health and BioMed Central.

Open Access Research article

Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana

Francis JMK Damalie13*, Edward T Dassah12, Emmanuel SK Morhe12, Emmanuel K Nakua2, Harry K Tagbor2 and Henry S Opare-Addo12

Author Affiliations

1 Komfo Anokye Teaching Hospital, Kumasi, Ghana

2 School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

3 Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, P. O. Box KS 1934, Kumasi, Ghana

For all author emails, please log on.

BMC Women's Health 2014, 14:90  doi:10.1186/1472-6874-14-90

Published: 29 July 2014

Abstract

Background

Misoprostol has become a popular over the counter self-administered abortifacient in Ghana. This study aimed to compare the socio-demographic characteristics and clinical complications associated with misoprostol and non-misoprostol induced abortions among patients admitted to a tertiary public health facility in Ghana.

Methods

This was a cross sectional study conducted at the gynaecological ward of Komfo Anokye Teaching Hospital (KATH), over a four-month period using a structured pre-tested questionnaire. Data were analysed using Chi-square, Fisher’s exact and student t-tests. Factors associated with severe morbidity were examined using Poisson regression with robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant.

Results

Overall, 126 misoprostol users and 126 misoprostol non-users were recruited into the study. About 71% of the clients had self-induced abortions. Misoprostol users were more likely to be younger (p < 0.001), single (p < 0.001), nulliparous (p = 0.001), of higher educational background (p = 0.001), and unemployed (p < 0.001), than misoprostol non-users. Misoprostol users were more likely than non-users to undergo termination of pregnancy because they wanted to continue schooling (p < 0.001) or were not earning regular income to support a family (p = 0.001). Overall, 182 (72.2%) of the women (79.4% misoprostol users vs. 65.1% misoprostol non-users; p = 0.01) suffered severe morbidity. Nulliparous women (adjusted RR, 1.28; 95% CI, 1.08-1.52) and those who had induced abortion after 12 weeks’ gestation (adjusted RR, 1.36; 95% CI, 1.18-1.57) were at increased risks of experiencing severe morbidity. The association between mode of abortion induction and severe morbidity was not statistically significant (p = 0.06).

Conclusion

Self-induced abortions using misoprostol is a common practice among women in this study; nearly three quarters of them suffered severe morbidity. Nonetheless, severe morbidity among misoprostol users and non-users did not differ significantly but was directly related to the gestational age at which the induced abortions occurred. Health education on the dangers of self-induced abortions and appropriate use of medication abortion could help reduce complications associated with induced abortions in Ghana.

Keywords:
Misoprostol; Client characteristics; Induced abortions; Severe morbidity; Ghana