Abstract

Background; It is estimated that over 30 million abortions are performed annually, about 19 to 20 million of these abortions are done by individuals without the requisite skills or in an environment below minimal medical standards or both. A number of reproductive age women die daily arising from unsafe abortion and some suffer from severe mental depression.

Aim: This study is aimed at determining the prevalence and risk factors associated with induced abortion among students of the University of Buea.

Method: This study was a cross sectional study at University of Buea from April 2022 to May 2022. A pretexted structured questionnaire was used to collect data. A sample of 288 respondents were required for this study, stratified random sampling was used to sample 300 respondents. Data collected was cleaned, coded and entered into Microsoft excel 2013.

Results: Majority of the participants were aged between 20 to 24 years. The prevalence of induced abortion was 14.0%. Majority of the participants were aware of induced abortion and had sufficient knowledge (63.3%). Most participants had a negative attitude (82.0%), towards induced abortion and the major reason for an induced abortion was if the woman’s life is at risk.

Conclusion: Students of the University of Buea have a good knowledge of induced abortion but show a negative attitude and poor practice of induced abortion.

CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study

Abortion is the termination of a pregnancy before fetal viability, abortion can be spontaneous due to complications during pregnancy or can be induced. Induced abortion can be therapeutic or elective, it can also be classified as safe and unsafe abortions. Spontaneous abortion or a miscarriage may arrive as a shock to the mother as it is sudden and unexpected, therapeutic abortion is one that is done for medical purpose and in an elective abortion the woman request a voluntary termination of her pregnancy here time maybe available for the woman mentally prepare herself for the changes [1].

According to the World Health Organization (WHO) abortion is said to be safe when performed by persons with the necessary training and skills and in an environment meeting minimal medical standards. And unsafe Abortion as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards or both, Most at time is carried out in secrecy, which makes it difficult to determine the exact incidence of the condition [1].

Globally, approximately 200 million pregnancies occur each year, it is estimated that over 30 million abortions are performed annually [2]. About 19-20 million of these abortions are done by individuals without the requisite skills or in an environment below minimal medical standards or both. In Africa, about 4.2 million abortions occur each year with an unsafe rate of 22 per 1000 women. In Cameroon about 25% abortions occur each year. The estimated maternal mortality ratio attributed to unsafe abortion in Cameroon was 90 to 100,000 live births. This is a huge number which could be controlled if abortions were done safely, unsafe abortion is responsible for 25% of maternal deaths in Cameroon consequently, and abortion is one of the leading causes of maternal mortality in Cameroon [3].

The performance of illegal abortion remains one of the biggest issues in Cameroon, making the government stick with the 2007 penalty code, the 2007 penalty code stipulates that the performance of an abortion is illegal unless the mother is proven to be under health danger or when the pregnancy is a product of rape[4]. It is clear that despite the fact that abortion practice remains restricted, it is not uncommon, it is reasonable that most of these could be done under unsafe conditions. Reported methods used to induce these unsafe abortion range from Trans -cervical foreign bodies, injections, unspecified medications and diverse plants [38].  Furthermore, the difference in social class creates a gap between women who can afford medical services and poorer ones who attempt abortion by self-medication or unsafe methods. The lack of information, the ignorance and the scarce knowledge on processes to obtain a legal abortion has led to an increase unsafe abortion [4].

Save abortion is an important element of reproductive health care, which involves a range of medical and related health services including counselling, contraception and referrals to other reproductive health care services as appropriate [1]. In some countries, some women see abortions as a fertility regulation practice that women use in the absence of contraceptives or when contraceptive fails. There are controversies surrounding the practice of abortion especially in developing countries of Africa, a good number of people in these countries given their religion and cultural background frown at this practice [4].

In a cross sectional study conducted by Bongfen et al., in 2019 to assess knowledge on the awareness of abortion laws and determinants of abortion in Buea, a total of 224 women were sampled and the prevalence of induced abortion was 21% [2]. The major determinants of abortion among these women were desire to stay in school (28%), fear of parents (28%), and shame of being pregnant out of wedlock (26%). furthermore, many women are not aware of the situations where abortion is allowed and hence some still undertake illegal abortion even when they find themselves in situations deserving a legal abortion. Induced abortion is still common in Buea, Cameroon despite the fact that it is illegal [2].

Abortion (especially unsafe) may have serious health consequences and cause complications such as hemorrhage, sepsis and uterine perforation. Acute complications of induced abortion include; infection, cervical and uterine trauma and hemorrhage. Long-term post-abortion complications include secondary infertility. Besides the short and long-term complications, adolescents’ also suffer with emotional problems which may be due to social stigma [5].

The controversy on abortions inhibits research and treatment on its impact on women’s mental health, thus clinicians do not identify adverse psychological outcome to abortion leaving many women untreated [6]. A number of reproductive age women die daily arising from unsafe abortion. Some suffer from severe mental depression, several research studies have been done on the effects of abortion on the mental health though reviews have been inconclusive. Some studies lean towards the inference that women do have an increased risk of psychological problems following abortion. In India the pressure of myths and society may add to women’s stress.  Throughout the world unsafe abortion is responsible for 25% of maternal death. This study is focused on the prevalence and risk factors of induced abortion [6].

1.2 Problem Statement        

In Cameroon, as in many African countries, induced abortion is restricted by law. A majority of the abortions are performed secretly often under unsafe conditions. Recent advances in education available to girls, the trend towards later age at marriage which tends to increase the incidence of premarital sex coupled with a low prevalence of contraceptive use. Due to the fact that many young girls do not regularly or correctly practice contraception since some African laws do not permit adolescents to have access to contraceptives consequently many of them resort to unintended pregnancy. The lack of knowledge about abortion and abortion laws, tends many females to resort to an unsafe abortion, thereby endangering their lives and health. The exact incidence of abortion is difficult to determine because it is illegal in many countries, and is shrouded in secrecy in most places. It is estimated that over 60% of unintended pregnancies around the world are among youths and this leads to a high prevalence of unsafe abortion with increased risk factors and complications [4].

The purpose of the study is to assess the risk factors of induced abortion among students of the University of Buea.

1.3 Research Questions

1. What is the prevalence of induced abortion among students at the University of Buea?
2. What is the level of knowledge of induced abortion among students of the University of Buea?
3. What is the attitude of students towards induced abortion?
4. Do students of the University of Buea practice induce abortion?

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