Compilation Of Bibliography On Abortion In Nigeria (2009-2012)
Abortion, especially when induced, represents a significant burden on women, the community and society in its portrayal of complications of morbidities and mortality. This is especially true in developing countries where socioeconomic inequalities contribute to this condition, mostly due to the consequences of unintended pregnancies. This informs the study to examine the bibliography on abortion at the Federal Medical Center, Makurdi.
The high induced abortion prevalence brings to the fore the health burden of this condition in Nigeria, especially in the middle-belt region and the need to urgently explore ways of reducing its effects. The study serves as a template to understanding sufferers of this condition and the need for further studies that would help in understanding how to manage them better. It also suggests that the most cost effective approach to solving the problem may be a targeted health education on the short term and an effective contraceptive knowledge, access and usage campaign with increased access to reproductive health services on the long term.
1.1 Background of Study
Abortion is the removal or explusion of an embryo or foetus from the uterus, resulting or causing its death. This can be spontaneously as miscarriage or other meals. “Abortion” can refer to an induced procedure at any point during human pregnancy. It is sometimes medically defined as either miscarriage or induced termination before the point of variability. Through history, abortion has been induced by various methods and the moral and legal aspects of abortion is subject to intense debate in many parts of the world/Jones et al …. 2004).
However, a clearer definition of Abortion is the removal of a growing embryo or foetus from uterus from which it is attached. This general definition covers spontaneously abortion (Miscarriage) and induced abortion but distinguished both from premature birth. Live or still. Golden (2001) stated that certain authorities seem to complicate the issue by defining abortion as termination, expulsion or detachment of foetus or fertilized ovum before its time of viability. In general, a foetus is not viable before the 18thweeks of gestation. The following medical terms are used to categorize abortion.
1. Spontaneous Abortion (Miscarriage):
Spontaneous abortion, according to Mules (2001) is the sudden termination or explosion of the foetus/pregnancy. It is characterized by complaints of feeling of uneasiness before the unset of specific signs and symptoms, by the mother such as vaginal bleeding that is, brown spotting or bright red blood. Spontaneous abortion can be due to accidental trauma or natural causes, most miscarriages are due to uncorrected replication of chromosomes; they can also be caused by environmental factors.
2. Induced Abortion:
This is an abortion brought about by interference either by therapeutic or elective abortion as a result of deliberate human action. (Roche, 2004).
3. Therapeutic Abortion:
An abortion performed either
- To save the life of the pregnant women
- To preserve the woman’s physical or mental health.
- Terminate pregnancy that would result in a child born with a congenital disorder that would be fatal or association with significant morbidity.
- Selecting reduce the number of foetus to lessen health risks association with multiple pregnancies.
In United Kingdom, legal termination of pregnancy is a therapeutic procedure carried out under the terms of the 1967 abortion act (United Kingdom Abortion Act, 2011). Before this type of abortion can be carried out 12 registered medical practitioners should be of the opinion that the pregnancy should be terminated and consent must be obtained from husband and wife. The procedure is performed after an agreement must have been reached between the two doctors.
4. Elective Abortion:
This is an abortion performed at will by an individual in contravention of the Abortion Act (United Kingdom Abortion Act, 2011). This type of abortion of performed for any other reason. Such procedures are illegal and punishable by imprisonment especially in country like Nigeria. It is attempted by unqualified, non-expert person or non-medical (quack) practitioner. It can also be done by patients herself by ingesting corrosive substances such as taking blece, potash, lime or excessive salt.
The world-wide legal states of abortion ranges from complete prohibition to elective procedures at the request of the pregnant woman. Olitan (2010) opined that in the environmental concerns. Social-economic development and recognition of the right of women to control their own fertility and aided by technological innovational. Abortion has gradually emerged from an aura of social ambivalence. However, abortion has continued ranging debates in political, social, medical, theological and legal fields (Christian 1999). To this end, two major camps has emerged namely:
- The pro-choice
- The pro-life
The pro-choice fights for the legalization of abortion and hence that a woman should have the right to decide whether or not to have her baby while pro-life activist on the other hand fight for the right of the unborn child to live and hence are vehemently opposed to the legalization of abortion (Christian 1999).
1.2 Statement of Problem
In Nigeria, where in a study by Orji VK et al. in Port Harcourt, eighty percent of women interviewed in a survey said they have had an abortion at least once in their lifetime (assumed to be the highest rate in the world), induced abortion poses a real danger of being unsafe. There are seemingly many reasons for performing an abortion which have been identified in some studies. Social vulnerability implies a higher risk of induced abortion. For example, Svanemyr and Sundby working with adolescent women in Cote d’ivoire found that these women chose abortion because they cannot count on economic and practical assurance from parents in feeding and raising the child. Psychological aspects are also implied as effects of induced abortion.
Strategies recommended to prevent induced and/or unsafe abortion are myriad. They range from facilitating access to contraceptives, providing sexuality education11, improving the health care system18, empowering women and providing free pregnancy care to liberalization of the abortion law19. In all, it is believed that reducing the incidence of unwanted pregnancy and subsequently unsafe abortion can significantly impact the reproductive health of women in Nigeria. Medical practitioners, politicians, academicians and spouses23 are needed to make this a reality.
This study attempts to identify the prevalence of induced abortion in Federal Medical Center, Makurdi, a hospital in North Central Nigeria and identify risk factors which influence it. The findings in this study will be a useful part of the measures and interventions aimed at preventing induced abortion in the region.
1.3 Objectives of Study
- To compile a bibliography on abortion among women admitted at the Gynaecological ward of the Federal Medical Centre, Makurdi between January 2009 and 2012 and compare it to the prevalence of spontaneous abortion among the same group of women in the same period.
- To identify determinants that may influence induced abortion among women admitted for the condition at the Gynaecological ward of the Federal Medical Center, Makurdi between January 2009 and 2012 and compare the presence of these determinants among women admitted for spontaneous abortion at the same ward during the same period.
- Based on the findings above, make recommendations on preventive strategies for the prevention of induced abortion.
There is no statistical difference in the presence of determinants in women admitted for induced abortion compared with those admitted for spontaneous abortion at the Federal Medical Center, Makurdi.
1.5 Justification for the Study
Among the strategies used in the reduction of morbidity and mortality due to abortions worldwide, prevention seem to make the most impact. In the preventive aspect, two leading strategies leap out; provision of contraceptive services and effective education of women. Of these two, it is obvious that the most cost effective one is providing adequate sex education.
The link between social factors and the presence of unwanted pregnancies and subsequently induced abortion has been established. It is believed that adequate representation of the influence of these factors in compelling women to resort to induced or unsafe abortion should be sought out to help in formulating policy for intervention.
In Nigeria, the clinical and socioeconomic characteristics of women that commit induced abortion as a subset of women of reproductive age group have not been studied in recent times and in Benue State, not at all. Also, the prevalence of induced abortion and its determinants have not been studied before at the Federal Medical Centre, Makurdi.
Conclusion and Recommendation
Prevention of unsafe abortion is an imperative public-health goal. An understanding of the induced abortion patient profile in this setting, and the role that some of these determinants play in women obtaining induced abortions, can assist policy makers and program managers in targeting those persons at highest risk of opting for unsafe abortions. We have shown that these women are more likely to be younger, unmarried, single nulliparous and if pregnant, may abort in the first trimester when presenting at the Federal Medical Center, Makurdi. This group has prevalence higher than the estimated national value and as such represent a heavier burden of preventing and managing this health problem.
It is believed that preventive strategies aimed at this specific group enumerated above in terms of women empowerment, health education tha is specific on reducing unwanted pregnancy and contraceptive awareness, providing contraceptive access and the establishment of a early pregnancy unit that can offer counseling to any woman after her first or second missed period may go a long way to ameliorate the effect of this condition.
It is hoped that this finding will help in contributing to all the efforts being made in reducing abortion morbidity especially induced, unsafe abortion in Benue state and indeed the nation.
Compilation Of Bibliography On Abortion In Nigeria (2009-2012)
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