Is There a Relationship between Repeat Induced Abortion and Current Use of Contraception among Women in the Reproductive Age? A Study in Ghana

Aims: Some women in the developing world use abortion to regulate fertility and space childbearing. However, repeat induced abortion has become common and it’s linked to increased risk of adverse outcomes in future pregnancies. The aim of this study was to determine the relationship between repeat induced abortion and current use of contraception among women in Ghana.

Study Design: A secondary analysis of cross-sectional survey data.

Place and Duration of Study: The study was conducted in Ghana between July 2019 and August 2019.

Methodology: Data on a weighted sample of 4595 women aged 15-49 years with a lifetime history of induced abortion from the 2017 Ghana Maternal Health Survey were analysed using Chi-square (χ2) test and multivariable survey logistic regression in STATA/IC 15.0. Statistical significance was set at the 5% level. The adjusted odds ratio was estimated.

Results: Out of 4595 women, 1591 (34.6%) experienced repeat-induced abortion. Current use of contraception was 36.7% (CI: 34.7-38.7). The majority used modern contraceptives (78%). The commonly used methods were injectables (20.3%), implants (19.7%), pills (16.6%) and rhythm (16.2%). After adjusting for potential confounding, repeat induced abortion was not significantly associated with current use of contraception. However, age, marital status, place of residence and ecological zone of residence were associated with current use of contraception. For instance, rural women with a history of repeat induced abortion were 1.3 times (AOR=1.27, 95% CI: 1.02-1.59, p=0.036) more likely to be on contraception compared to urban women.

Conclusion: Women’s previous abortion experience was not independently associated with their current use of contraception. Other factors were significantly associated with women’s use of contraception post-abortion. Further research is recommended to clearly understand this phenomenon among Ghanaian women in the reproductive age group.