Induced second trimester abortion and its determinants in East Gojjam public hospitals

Abstract

Induced second-trimester abortions are increasing globally, particularly in developing countries such as Ethiopia. Previous studies have primarily focused on the prevalence of first-trimester abortions. However, reducing abortion-related maternal morbidity and mortality is difficult without decreasing second-trimester abortions. To assess the proportion of induced second-trimester abortions and associated factors among women seeking abortion care services at public hospitals of East Gojjam Zone, Ethiopia, 2024. An institution-based cross-sectional study was conducted at public hospitals of the East Gojjam Zone from January 15 to February 15, 2024, involving 257 women seeking abortion care services. A systematic sampling technique was used. Data were collected through face-to-face interviews and chart reviews. The data were entered using EPI Info version 7 and analyzed using SPSS version 25. Bivariate and multivariable logistic regressions were performed. An odds ratio with a 95% confidence interval and p-value ≤ 0.05 was considered statistically significant. The proportion of induced second-trimester abortion was 64 (24.9%). The main reasons reported by women for seeking abortion were incest-related pregnancy 88 (34.2%), fear of school dropout 52 (20.2%), financial problems 49 (19%), and rape 46 (17.9%). Rural resident (AOR = 3.00, 95% CI 2.02, 8.81), woman who had a history of the irregular menstrual cycle (AOR = 3.53, 95% CI 1.28, 9.77), delay to suspect pregnancy (AOR = 3.77, 95% CI 2.31, 11.87), and afraid to have an abortion (AOR = 6.77, 95% CI 3.23, 20.02) were significantly associated with the proportion of second trimester induced abortion. The findings of this study showed that the proportion of induced second-trimester abortion was high. Strengthening health services that provide women with information, build confidence, and support early decision-making, which is essential. Special attention should be given to pregnant women from rural areas.

Keywords: Ethiopia; Facility based; Induced abortion; Proportion; Second trimester.