Knowledge, Perception and Factors Associated with Self Induced Abortion among Female Medical Students of Kampala International University
The knowledge and perception of abortion has highly influenced the choice to undergo self-induced abortion. The identified outcomes of which have continued to increase maternal morbidity and mortality. This is to say self-induced abortions which are mostly done by unsafe methods apart from claiming lives, often result in serious health problems. The main purpose of this study was to determine the knowledge on factors and perception of females’ medical student on self-induced abortion. This was a cross-sectional study. About 185 females’ medical students participated and filled self-administered questionnaire following their consent to participate in the study. Data collected were entered into excel spread sheet and analysed with the help of excel. Results were presented on tables. Out of 185 participants, 165(89.2%) said unsafe abortion is abortion done by inflicting trauma, 185(100%) agreed that comprehensive abortion should be done by medical practitioner, 185(100%) said abortion can lead to death, infertility and psychological trauma. 66(35.7%) responded that abortion is safe at any age while 119(64.3%) said no, it is not safe at any age. 54(29.2%) said abortion can be done anywhere as long as drug is available while 131(70.8%) responded no, 172(92.9%) said abortion is right of every female in Uganda while 13(7.0%) disagreed. Also, 185 (100%) said pregnancy caused by raped as one of the factors triggering self-induced abortion, stigma 178(96.2%), fear of forced marriage 168(90.8%), fear of responsibility and denial by father 150(81.1%) and desire to finished school 110(59.5%). Response of participants on perception of female students on self-induced abortion. 139(75.1%) said abortion should be permitted, 151(81.6%) believe contraceptives used can reduced abortion incidence, 157(84.9%) blamed inadequate sex education for self-induced abortion. 131(70.8%) believed free access to abortion care can reduced mortality or morbidity related to abortion complications. 149(80.5%) said marriage can reduce self-induced abortion, 70(37.8%) said friends should be advised to go for abortion to avoid unplanned pregnancy while 36(19.5%) said abortion is for family planning and 149(80.5%) disagreed that it is not a form of planning a family. This study concludes that the females’ folks have knowledge on self-induced abortion however, their perception shows abortion should be the right of every female and not only on medical basis.
Keywords: Knowledge, Perception, Self-Induced Abortion, Female Medical Students.
The practice of abortion is as old as pregnancy and it threatens the health and social life of females; its contribution to maternal deaths is a major case in point globally . In ancient Greek Hippocrates (460 -357 B.C) referred to abortion in his oath. The oath forbids the use of pessaries (vaginal suppositories) to induce abortion. In Aristotle’s (354-322B.C) view, abortion if performed early is not the killing of something human. He permitted abortion if birthrate is too high, but only at a stage before life and sense had begun in the embryo. In ancient cultures, owing to absence of pregnancy tests and tools for early abortions, the baby is delivered prematurely but alive and the abortion process completed by infanticide of the born child.
Depending on individual sociocultural background, the issue of abortion is viewed in different perspectives. On one hand, spontaneous abortion in Africa is believed to be an unfortunate situation usually attributed to the evil deeds of an enemy, which may be a close family relative. The victim may resort to seeking psych spiritual solutions to unravel the mystery depending on her socio-religious background .
On the other hand, induced abortion is considered to be the intentional termination of a pregnancy before the fetus can live independently; it may be commenced voluntarily based on a woman’s personal choice due to various reasons or it may be commenced in-order to preserve the health or save the life of a pregnant woman . An unsafe abortion may be self-induced and, in most instances, various dangerous and or unhygienic methods are used .
Worldwide, nearly one in ten pregnancies ends in unsafe abortion; It is estimated by the World Health Organisation that as many as 4.4 million abortions are sought by adolescent girls each year . Compared to adults, adolescents’ delay the process, resort to unskilled persons to perform it and use dangerous methods which may lead to complications or may be fatal.
Developing countries are the most plagued with almost all unsafe abortions with 99% abortion related deaths cases . About one-quarter of the unsafe abortions in Africa are among adolescents and is estimated to be higher than that obtainable in any other region in the world . Unskilled practitioners are the last resort when adolescents can’t access safe abortion. Such practitioners are reported to use variety of unsafe methods which may include but not limited to insertion of a sharp object into the uterus, physical abuse such as jumping or falling from high places, vigorous sexual intercourse over long periods, prolonged and hard massage to manipulate the uterus, or repeated blows to the stomach .
In Uganda and most African countries, the case is not different as abortion is considered illegal unless the woman’s life at risk .
Induced abortion is medically safe when WHO- recommended methods are used by a skilled individual, with nonhazardous equipment and in sanitary facility, less safe when only one of those two criteria is met and least safe when neither is met. Many women in Africa undergo unsafe (i.e. less safe or least safe) procedures that put their wellbeing at risk .
Unsafe Abortion poses negative consequences beyond its immediate effects on individual women’s health. Treating complications increases the economic burden on poor families and incurs considerable costs to already struggling systems public health systems .
Between 2010 and 2014, an estimated 56 million induced abortions occurred each year worldwide. This number represents an increase from 50 million annually during 1990-1994, mainly because of population growth. The highest annual rate of abortion in 2010-2014 was in the Caribbean, estimated at 59 per 1,000 women of reproductive age, followed by South America at 48 per 1000 women. The lowest rates were in Northern America, at 17 per 1,000 and in Western and Northern Europe at 16 and 17 per 1,000 respectively . The proportion of abortions worldwide that occur in developing regions rose from 76% to 88% between 1990 -1994 and 2010-2014. Women in developing regions have a higher likelihood of having an abortion than those in developed regions-36 vs.27 per 1,000 . The Ugandan constitution in article 22, item 2 states; No person has the right to terminate the life of unborn child except as may be by law. However, what is authorised by law remains poorly understood. According to a study on ‘Incidence of Induced Abortions in Uganda’ , an estimated 314,304 induced abortions occurred and 128,682 women were treated for abortion complications. Statistics on abortion rates by region given by this study shows the highest incidence at 77 per 1,000 women in Kampala with the western region recording the least incidence of; 18 per 1,000 women. Deaths and disabilities related to unsafe abortions are difficult to measure. This is because they occur following a secret or illegal procedure. Stigma and fear of punishment discourage reliable reporting of incident thus maternal deaths and disabilities resulting from unsafe abortions are grossly underreported. This research will assess the knowledge, perception and factors associated with self-induced abortion among medical students of KIU –WC.
This study concludes that the females’ folks have knowledge on self-induced abortion however, their perception shows abortion should be the right of every females and not only on medical basis.
This study recommends more awareness on females’ youth against their perception to see self- induced abortion as wrong and can lead to fatal complications other than seen it as a fight to freedom. This called for the stakeholders to intensify campaign and educate the females on the risk of legalizing abortion outside medical reasons.
1. Guttmacher. (2009). Unintended pregnancy and abortion in Uganda. In Brief. https://doi.org/10.1017/S0021932010000507
- Oyefabi, A., Nmadu, A., & Yusuf, M. (2016). Prevalence, perceptions, consequences, and determinants of induced abortion among students of the Kaduna State University, Northwestern Nigeria. Journal of Medicine in the Tropics. https://doi.org/10.4103/2276- 192230
- World Health (2014). Clinical practice handbook for Safe Abortion. WHO.
- Sedgh, , Singh, S., Shah, I. H., Hman, E., Henshaw, S. K., & Bankole, A. (2012). Induced abortion: Incidence and trends worldwide from 1995 to 2008. In The Lancet. https://doi.org/10.1016/S0140-6736(11)61786-8
- Ganatra, B., Gerdts, C., Rossier, C., Johnson, B. R., Tunçalp, Ö., Assifi, A. & Alkema, L. (2017). Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. The Lancet. https://doi.org/10.1016/S0140- 6736(17)31794-4
- Rominski, D., & Lori, J. R. (2014). Abortion care in Ghana: a critical review of the literature. Afr J Reprod Health. https://doi.org/10.1111/jmwh.12243
- Neal, S., Mahendra, S., Bose, K., Camacho, A. V., Mathai, M., Nove, A. & Matthews, Z. (2016). The causes of maternal mortality in adolescents in low- and middle-income countries: Systematic review of the literature. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-016-1120-8
- Singh, S., Remez, L., Sedgh, G., Kwok, L., & Onda, T. (2018). Abortion Worldwide 2017: Uneven Progress and Unequal Access. Guttmacher Institute. https://doi.org/10.1043/0003- 9985(2003)127<193:IASOCT>2.0.CO;2
- Prada, E., Atuyambe, L. M., Blades, N. M., Bukenya, J. N., Orach, C. G. and Bankole, A. (2016). Incidence of Induced Abortion in Uganda, 2013. PLoS One, 11(11):e0165812. doi: 10.1371/journal.pone.0165812. PMID: 27802338; PMCID: PMC5089684.
- Ugwu, C. N., & Eze, V. H. U. (2023). Qualitative Research. IDOSR of Computer and Applied Science, 8(1), 20–35.
- Ugwu Chinyere Nneoma, Eze Val Hyginus Udoka, Ugwu Jovita Nnenna, Ogenyi Fabian Chukwudi and Ugwu Okechukwu Paul-Chima (2023). Ethical Publication Issues in the Collection and Analysis of Research Data. NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES (NIJSES) 3(2): 132-140.
- Pew Forum on Religion and Public Life. Tolerance and tension: Islam and Christianity in sub-Saharan Africa.Washington: Pew Research Centre; 2010.
- Harris, L. H., Debbink, M., Martin, L., & Hassinger, J. (2011). Dynamics of stigma in abortion work: findings from a pilot study of the Providers Share Workshop. Social science & medicine (1982), 73(7), 1062–1070. https://doi.org/10.1016/j.socscimed.2011.07.004
- Olukoya, A. A., Kaya, A., Ferguson, B. J., & AbouZahr, C. (2001). Unsafe abortion in adolescents. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 75(2), 137–147. https://doi.org/10.1016/s0020-7292(01)00370-8
- Grossman, D., Holt, K., Peña, M., Lara, D., Veatch, M., Córdova, D., Gold, M., Winikoff, B., & Blanchard, K. (2010). Self-induction of abortion among women in the United States. Reproductive health matters, 18(36),136–146. https://doi.org/10.1016/S0968-8080(10)36534-7
- Dotia Tusingwire. (2023). Evaluation of the factors that contribute to patient self-medication in outpatient department (OPD) at Kabwohe Health Centre IV. IDOSR Journal of Scientific Research. 8(2), 29-39.
Precious G. (2023). Knowledge, Perception and Factors Associated with Self Induced Abortion among Female Medical Students of Kampala International University. IDOSR JOURNAL OF APPLIED SCIENCES 8(3) 111-117. https://doi.org/10.59298/IDOSR/2023/10.2.1418