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Determinants of abortion among clients coming for abortion service at felegehiwot referral hospital, northwest Ethiopia: a case control study

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      According to the World Health Organization (WHO) estimate, one-third of pregnancies end in miscarriage, stillbirth, or induced abortion in the world. There are various reasons for a woman to seek induced abortion. However, limited information is available so far in the country and particularly in the study area. Therefore, the aim of the current study was to identify the determinants of induced abortion among clients coming for abortion care services at Bahirdar Felegehiwote referral hospital, Northwest Ethiopia.


      Institutional based unmatched case-control study was conducted from September to December 2014. Interview administered questioner was used to collect primary data. Enumeration and systematic random sampling (K = 3) method was used to select 175 cases and 350 controls. A binary logistic regression model was fitted to identify determinant factors. Odds ratio with 95% CI was computed to assess the strength and significance of the association.


      All sampled cases and controls were actually interviewed. The likelihood of abortion was higher among non-married women [AOR: 18.23, 95% CI: 8.04, 41.32], students [AOR: 11.46, 95% CI: 6.29, 20.87], and women having a monthly income of less than 500 ETB [AOR: 11.46, 95% CI: 6.29, 20.87]. However, the likelihood of abortion was lower among women age greater than 24 years [AOR: 0.29, 95% CI: 0.11, 0.79] and who had the previous history of induced abortion [AOR: 0.31, 95% CI: 0.15, 0.65].


      The study identified being non-married, student, women age less than 24 years, having the previous history of induced abortion, and low monthly income as an independent determinant of induced abortion. Interventions focused on the identified determinant factors are recommended.

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      Most cited references 12

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      Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008

       E Åhman,  IH Shah (2011)
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        Induced abortion in Denmark: effect of socio-economic situation and country of birth.

        Equal access to health care is considered a key in Scandinavian healthcare policy. However, problematic differences between the socio-economic situation of immigrants and that of native Scandinavians are increasingly challenging this aspect of the Scandinavian welfare model. The present study focuses on how socio-economic characteristics and country of birth are associated with induced abortion. A structured questionnaire was used to collect information among 1351 women requesting abortion and a control group of 1306 women intending birth. The strongest factor associated with the decision to have an abortion was being single (OR 39.1; 23.8-64.2), followed by being aged 19 years or below (OR 29.6; 13.4-65.5), having two children or more (OR 7.05; 5.29-9.39) and being unskilled (OR 2.48; 1.49-4.10), student (OR 2.29; 1.52-3.43) or unemployed (OR 1.65; 1.11-2.46). When evaluating the effect of social exposure on abortion among Danish-born and foreign-born women, the higher rate of abortion among non-Westerners was found to be caused by the composition of non-Westerners more often being unemployed, having a low income and having two or more children rather than the fact that they are coming from a non-Western country. Immigrant women comprise a vulnerable group, with a poor socio-economic status. This situation exposes immigrant women to increased risk of induced abortion. In a society with an increasing heterogeneous population, the vulnerable situation of immigrant women has to be addressed, if equal access to health care is to be maintained.
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          Unsafe abortion: the silent scourge.

           D. Jay Grimes (2002)
          An estimated 19 million unsafe abortions occur worldwide each year, resulting in the deaths of about 70,000 women. Legalization of abortion is a necessary but insufficient step toward improving women's health. Without skilled providers, adequate facilities and easy access, the promise of safe, legal abortion will remain unfulfilled, as in India and Zambia. Both suction curettage and pharmacological abortion are safe methods in early pregnancy; sharp curettage is inferior and should be abandoned. For later abortions, either dilation and evacuation or labour induction are appropriate. Hysterotomy should not be used. Timely and appropriate management of complications can reduce morbidity and prevent mortality. Treatment delays are dangerous, regardless of their origin. Misoprostol may reduce the risks of unsafe abortion by providing a safer alternative to traditional clandestine abortion methods. While the debate over abortion will continue, the public health record is settled: safe, legal, accessible abortion improves health.

            Author and article information

            [1 ]Debrebrhan Hospital, Debre Berhan, Ethiopia
            [2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, ; P.O.Box: 360, Gondar, Ethiopia
            [3 ]College of Medicine and Health Sciences, University of Gondar Hospital, Gondar, Ethiopia
            Contracept Reprod Med
            Contracept Reprod Med
            Contraception and Reproductive Medicine
            BioMed Central (London )
            14 February 2017
            14 February 2017
            : 2
            5683317 38 10.1186/s40834-017-0038-5
            © The Author(s). 2017

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

            Funded by: There is no funding source for this study
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            © The Author(s) 2017

            ethiopia, induced abortion, case-control study


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