Unsafe abortions, major contributor to maternal morbidity and mortality in Ghana – Lecturer
Unsafe induced abortions are a significant contributor to maternal morbidity and mortality in Ghana which raises serious public health concerns, Dr Susan Ama Amuasi, a Lecturer at the Central University, has observed.
She said with the growing number of young populations globally and an ever-changing sociocultural environment and circumstances, there was a tendency for unwanted pregnancies and abortions.
According to her, most unsafe abortions were performed under the least safe conditions by untrained persons, using dangerous and invasive methods, a situation that was concerning.
Dr Amuasi, also a Reproductive Health Expert, speaking in an interview with the Ghana News Agency in Accra, said the unsafe abortion rate in Ghana was high with many vastly underreported and probably unreported, a situation she emphasised remained an issue of public health concern.
The 2017 Ghana Maternal Health Survey (GMHS), designed to provide data for monitoring the maternal health situation in Ghana, indicates that 76 per cent of pregnancies among women aged 15 to 49 in the 5 years preceding the survey ended in a live birth, with two per cent resulting in a stillbirth, 12 per cent miscarried, and ten per cent ending in an induced abortion.
Maternal mortality is the second leading cause of death among Ghanaian women and most maternal deaths in the country are due to unsafe abortions.
Data from the Ghana Health Service reveals that some 7,618 abortions were recorded among teenage girls in 2022, which translates into about 21 abortions (both safe and unsafe) each day of the year. The 2022 figure was a decrease of 10 per cent from that of the 2021 figure of 8,465.
In total, the year 2020, 2021 and 2022 recorded 24,108 abortions among teenage girls which are about 60 per cent of all abortions recorded in those years.
With these disturbing statistics, Dr Amuasi, who has researched extensively in reproductive health, therefore recommended that contraceptives and safe abortion services be made available and easily accessible to women who needed such services in Ghana, particularly in rural communities.
She noted that pregnancy and childbirth-related complications were a leading cause of death for women 15 to 19 years.
Data from the World Health organisation (WHO) reveals that each year between 4.7 per cent to 13.2 per cent of maternal deaths can be attributed to unsafe abortion.
The WHO says around seven million women are admitted to hospitals every year in developing countries, because of unsafe abortions.
The annual cost of treating major complications from unsafe abortion, the WHO further points out, is estimated at $553 million.
Dr Amuasi, speaking on the scope of the problem, said an estimated 30 women die for every 100,000 unsafe abortions in developed regions and explained that the number “rises to 220 deaths per 100,000 unsafe abortions in developing regions and 520 deaths per 100 000 unsafe abortions in sub-Saharan Africa.”
In Africa, nearly half of all abortions happen in the least safe circumstances with mortality from unsafe abortion disproportionately affecting women in Africa.
Referencing data from the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights worldwide, Dr Amuasi, said more than half of the pregnancies in Ghana were unintended and that in 2017, an estimated 23 per cent of all pregnancies in Ghana ended in abortions.
Nationally in 2017, the estimated pregnancy rate was 194 pregnancies per 1,000 women aged 15–49, and the unintended pregnancy rate was 103 per 1,000.
About half, constituting 53 per cent of all pregnancies nationally were unintended, ranging from 23 per cent in the Northern zone to 51 per cent in the Coastal zone and 66 per cent in the Middle zone, data from the Guttmacher Institute further states.
The 2016 GHS annual report, published in June 2017, indicates that out of the 1033 maternal deaths recorded, 56.6 per cent of the deaths were due to direct causes with Haemorrhage, being the leading direct cause of maternal death, representing 39 per cent.
Dr Amuasi, therefore, said providing safe abortion would prevent unsafe abortion, and that importantly, there was the need to undertake and intensify sexuality education as that could have positive impacts on young people’s sexual and reproductive health and their ability to make safe and informed decisions.
She said almost every abortion death could be prevented through education, the use of effective contraception, the provision of safe and legal abortions, timely care for complications and empowering females especially young girls.
She noted that in developing countries including Ghana, proper parental care was one of the keys to reducing unsafe abortions leading to deaths, especially among adolescents.