E.O. Cadmus1 and E.T. Owoaje1
Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
Abstract
Background: Unwanted pregnancies and unsafe abortion pose major health risks to women in the reproductive age group. Female undergraduates are particularly exposed to these risks. This study was carried out to assess the knowledge about complications and practice of abortion among female undergraduates of the University of Ibadan.
Methods: A cross-sectional study was conducted using structured, self-administered questionnaires, to collect data on respondents’ socio-demographic characteristics, sexual behaviour, knowledge about various complications of abortion and practice of abortion. Data was analyzed using SPSS version 14.
Results: A total of 425 students were interviewed, mean age of the undergraduates was 21.5± 2.8 years. Overall, 122 (29%) of the respondents had ever had sexual intercourse. Twenty five percent of those who were sexually active had ever been pregnant and 90% had terminated the pregnancy. The most common reason given for termination was that pregnancy was unplanned for. Most of the respondents 354 (83.3%) had a good knowledge about complications of abortion and mean knowledge score was 4.01±1.58 (range 0-5).
Conclusion: This group of students were aware of the risks associated with unsafe abortion; however, the abortion rate was still high. Sexual reproductive health interventions are needed on campus in order to equip female undergraduates with comprehensive knowledge and skills to reduce the likelihood of unplanned pregnancies.
Keywords: knowledge, abortion complications, female undergraduates, Nigeria.
Correspondence:
Dr. Eniola O. Cadmus
Department of Community Medicine,
University College Hospital, Ibadan,
Nigeria
E mail: eniyolacadmus@yahoo.co.uk.
Introduction
Unsafe abortion has been defined by the World Health Organization as a procedure for terminating unwanted pregnancy that is performed by someone lacking the necessary skills or in an environment lacking minimal medical standards or both.1
Unsafe abortions can endanger women’s reproductive health and lead to serious, often life-threatening complications. Furthermore, unsafe abortions impose a heavy burden on women and society by virtue of the serious health consequences that often ensue. In most African countries, abortion remains both unauthorized and unsafe and is a leading cause of maternal deaths accounting for a global average of 13% of pregnancy related fatalities.2 It has been documented that young adults are more likely to delay seeking termination, employ the use of unqualified and unskilled providers and also use dangerous methods to induce abortion.1 Annually, an estimated 2-4.4 million adolescents resort to abortion worldwide and a WHO estimate of unsafe abortion revealed that in the African region, youth aged between 15-24 years account for more than 50% of all abortion related mortality. 2
Young adults terminate unplanned pregnancies for various reasons; these include fear of expulsion from school, unstable relationships, financial instability and lack of support from the partner.3 In cases where early marriage or single mothers are unaccepted, the pregnancy not only represents an unwanted responsibility but also the end of hope of further education, financial advancement and improved social opportunities in life.3 Young women in the university environment are away from home for the first time and become free to experiment sexually especially without any parental supervision. For the young females, there is usually associated coercion from older students and the liberal atmosphere of the university, which are factors that further encourage this experimentation. Coupled with their lack of, or poor knowledge of contraception, quite a few usually end up with unwanted pregnancies and are quite often faced with the predicament of dealing with the problem thereof. Few studies have however documented the knowledge about complications and practice of abortion among young women in the university environment.
Unsafe abortion is of public health concern because of its dire reproductive health consequences and impact on maternal morbidity and mortality. Tackling this problem will go a long way towards achieving one of the Millennium Developmental Goals, which aims to reduce overall maternal mortality by two thirds by the year 2015. This study therefore aimed at determining the knowledge of complications and practice of abortion among the female undergraduates in the University of Ibadan.
MATERIALS AND METHODS
Study Area
The study was carried out in the University of Ibadan, located in the south western part of Nigeria; the university was founded in 1948 as Nigeria’s first tertiary educational institution. The university is mainly residential. There are four halls designated for female undergraduates; three of which are located on the main campus and a clinical students’ hostel, the Alexander Brown Hall which is on the grounds of the University Teaching Hospital about 5 kilometers away. The total population of female undergraduates resident on campus in the 2003/2004 session was 2, 887.
Study Design
The study was a cross-sectional survey carried out among female undergraduates aged between 15years to 30 years, resident in the halls on the campus of the University of Ibadan.
Sample size calculation
The sample size was based on a reference prevalence value of induced abortion rate among female undergraduates in the University of Benin which reported that 34% of the sample of female undergraduates interviewed had ever terminated a pregnancy.4