Abortion knowledge and experiences among young women and men in Accra, Ghana

Gates Open Res. 2020 Sep 7:3:1478. doi: 10.12688/gatesopenres.12961.2. eCollection 2019.

Abstract

Background : Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods : To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher's exact tests, and chi-square tests were performed. Results : Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women's most recent abortions, medication abortion (61%), surgical methods (26%), and unsafe methods categorized "least safe" (14%) were the initial or only methods used. Most women who accessed medication abortion initially or as their only method saw a pharmacist (40%) or no one (33%). Nearly one-quarter of women (n=16, 24%) who initially took tablets used more than one method. Conclusions : Despite experiences with abortion, most young people in this study were unaware of its legality and unsafe abortions occurred. More needs to be done to ensure young people understand the law and have access to safe methods, and that pharmacists are trained to provide appropriate doses and formulations of medication abortion.

Keywords: Accra; Ghana; Medication abortion; abortion access; family planning; sexual and reproductive health; urban youth.

Grants and funding

The initial study was funded by Marie Stopes International (grant: “Reproductive health decision making among urban youth in Accra, Ghana”). Findings from a related study (Contraceptive access and unintended pregnancy in Ghana) were presented as a poster at the International Conference on Family Planning (Investment title: Support to the 2018 and 2020 International Conferences on FP and Core Gates Institute Staff support; Investment ID: OPP1181398); publication of this study was supported by the Bill and Melinda Gates Foundation.