FACTORS ASSOCIATED WITH UNSAFE ABORTION AMONG YOUNG ADULTS (ADOLESCENT) IN EZIALA NSULU COMMUNITY IN ISIALA NGWA NORTH, ABIA STATE.
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Background to the study
Unsafe abortions refer to the termination of pregnancy performed by individuals who lack the requisite expertise or in settings with limited medical standards, or both. Abortion has been a prevalent practise throughout many civilizations worldwide, serving as a means to manage population growth and maintain social and economic stability (Ife, Ayodeji, & Richard, 2018). The prevalence of adolescent pregnancies resulting in induced abortions exhibits significant variation across nations, as seen by the respective rates of 17% in Slovakia and 69% in Sweden. According to Legesse, Solomon, and Teresa (2017), According to the United Nations (UN), an estimated annual occurrence of up to 3.2 million unsafe abortions involving adolescents is seen in underdeveloped nations. In contrast to adult women, teens have a heightened susceptibility to complications, including severe bleeding, septicemia, and mortality, due to the use of hazardous procedures. The prevalence of adolescent sexual behaviour and the subsequent occurrence of unwanted pregnancies have been increasing worldwide, making them significant factors in the overall incidence of unintended pregnancies. The occurrence of unintended pregnancies is a significant global public health issue, particularly among the teenage population. According to the International Project Assistance Services (IPAS, 2015), the global annual incidence of abortions is expected to range between 40 and 50 million, with around 20 million categorised as unsafe. On a global scale, a significant proportion of women experience mortality as a result of difficulties associated to childbirth and pregnancy (Ajewole, Fasoro, & Agbana, 2018).
The majority of worldwide maternal deaths that occur each year are concentrated in underdeveloped nations, such as Nigeria (Alvi, 2016). Abortion-related instances have been identified as the primary factors contributing to maternal mortality. In the year 2008, it has been reported that around 6.4 million abortions were place in Africa, as documented by Babatunde et al. (2016). These abortions were associated with a range of problems, some of which resulted in fatalities. According to the findings of Yogi, Prakash, and Neupane (2018), a comprehensive investigation including 115 countries throughout the period of 2003 to 2009 demonstrated that 7.9% of maternal mortalities were attributed to induced abortion. According to Lamina (2015), it has been shown that in Nigeria, a significant proportion of maternal mortality, ranging from 20% to 40%, may be attributed to abortion. The yearly number of recorded abortions in the country is believed to be about 610,000. Moreover, Kabiru (2016) also highlights that almost all of the abortions (97%) documented in the study were categorised as unsafe, indicating that they were conducted in substandard medical settings and/or by individuals without proper training. The possibility for under-reporting may contribute to an even larger number, since the availability of reliable data is often constrained in poor nations. Moreover, in nations where induced abortion is constrained by legal statutes or hindered by socio-cultural or geographical obstacles, as is the case in Nigeria, the acquisition of information pertaining to this procedure may prove to be challenging. Adolescent females are confronted with a significant vulnerability to experiencing unexpected pregnancies, which subsequently increases the likelihood of resorting to unsafe abortion practises. These circumstances may have profound and detrimental effects on their overall well-being and reproductive health.
According to a study conducted by IPAS (2017), it has been noted that on a global scale, around 40 women in dire circumstances undertake unsafe abortions every minute. It is noteworthy that at least one-fourth of these women fall between the age range of 15 to 19, indicating that adolescent girls are significantly affected by this issue. Additionally, it is asserted that in numerous developing nations, hospital data indicates that approximately 38-68 percent of females receiving medical care for abortion-related complications are under the age of 20. This conservative assessment places the estimated annual count of abortions among adolescents in developing countries within a range of 2 million to 4.4 million. Determining the precise number of complications, particularly mortality rates, arising from unsafe abortion in Nigeria poses a challenge. However, the Society of Gynaecologist and Obstetrician of Nigeria, in conjunction with Henshaw, have disclosed that an estimated 3,000 women succumb to complications stemming from unsafe abortions annually in Nigeria. Furthermore, it has been observed that over half of these fatalities involve adolescent females (Annas, George, Elias & Sherman, 2017).
Unsafe abortion is often associated with unintended pregnancies and consistently arises from engaging in unsafe sexual practises. Unintended pregnancies may manifest in women across several age groups, although it is noteworthy that teens have a disproportionately higher incidence. Unsafe sexual behaviour has become prevalent among teenagers, characterised by inconsistent and inappropriate use of condoms. Consequently, unexpected pregnancies often occur, leading to unsafe abortions and their associated consequences. According to IPAS (2017), it has been noted that teenagers have a higher tendency compared to adults to postpone obtaining an abortion, seek assistance from untrained individuals to carry out the procedure, use hazardous procedures, and delay seeking medical attention in the event of problems. Adolescents have a higher propensity to encounter various complications, including septicemia, internal organ damage, tetanus, sterility, severe per vaginal bleeding, incomplete abortion, septic abortion, ill health, infertility, and mortality for the woman.
Additionally, they may also face long-term consequences such as death or the development of lifelong conditions and disabilities, such as obstetric fistula (African Population and Health Research Centre (APHRC), 2017). Moreover, it has been widely acknowledged that teenagers constitute a significant at-risk population within the broader societal context. This phenomenon is especially conspicuous in Nigeria, where several socio-economic variables, including poverty and delayed healthcare seeking behaviour, contribute to an increased vulnerability among individuals, given the multifaceted problems and possibilities they encounter on a daily basis in a fast evolving global landscape. In low-income countries like Nigeria, unintended pregnancy and unsafe abortion are associated with various reproductive health issues, including sexually transmitted infections (STIs) such as HIV/AIDS. This is particularly detrimental to young individuals, as they are at a higher risk of contracting these infections through unsafe abortion practises. Regrettably, abortion continues to be a contentious matter within our culture, eliciting moral censure and often subjecting those involved in its implementation to social stigmatisation. Due to its unfamiliarity, the issue of abortion often elicits avoidance among individuals, particularly teenagers, resulting in a lack of access to essential information and assistance.
Consequently, individuals may make uninformed choices about their unintended pregnancies, potentially leading to adverse outcomes. Consequently, a significant proportion of abortion procedures are conducted clandestinely, sometimes by individuals without the necessary qualifications, hence leading to the occurrence of various difficulties. Despite the presence of technology improvements in the field of healthcare within our specific region in recent years, the overall practise of healthcare has remained largely unaltered on a global scale (World Health Organisation, 2016). This phenomenon may be attributed to the concentration of advanced technology and extensive knowledge inside established governmental or private healthcare institutions, which often adhere to stringent protocols pertaining to the provision of abortion services. Valley (2015) has found many techniques of unsafe abortion, which include the consumption of dangerous chemicals, physical interventions including the introduction of foreign objects or substances into the cervix or uterus, as well as external forces used to the abdomen, such as squeezing or massaging. Furthermore, previous research conducted on the abortion attempts of teenagers has shown that the process often includes the use of herbal tea. While this practise is not necessarily new, it may be influenced by certain cultural factors [Benson et al., 2015].
However, when considering the collective impact, it is evident that unsafe abortion, regardless of the specific method employed, poses a significant risk to women's reproductive health and the overall well-being of society. It is imperative that the underlying factors contributing to these egregious violations against women's reproductive health are promptly and effectively addressed. Unfortunately, there is a lack of substantial data or well documented literature on the dynamics of the increasing incidence of unsafe abortion, as well as the variables that contribute to this dangerous practise within our culture. Gaining an understanding of these key elements will provide valuable insights for educational practises and serve as a foundation for addressing the issue at hand in our society, ultimately working towards the protection and well-being of teenagers. This intervention has the potential to contribute to the preservation and promotion of health among adolescents, as well as the wider population, with implications for future generations. Furthermore, a comprehensive review of the existing literature pertaining to the current research done in the South Eastern region of Nigeria yielded no findings. To fill this knowledge gap and contribute to the existing literature, this study seeks to examine the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
Statement of the problem
Globally, it is estimated that around 47,000 maternal fatalities occur annually as a result of complications arising from unsafe abortion procedures (Boah, Bordotsiah & Kuurdong, 2019). Unsafe abortions may lead to several additional repercussions, including diminished productivity, financial strain on public healthcare systems, social shame, and enduring health complications including infertility (World Health Organisation, 2016). In the African region, an approximate annual occurrence of 8.3 million induced abortions has been calculated. These abortions are distributed as follows: 23% in West Africa, 28% in North Africa, 24% in South Africa, and 13% and 14% in Middle and Eastern Africa, respectively.
According to Chigbu et al. (2018), The user's text is too short to be rewritten in an academic manner. The majority of abortion-related fatalities globally are concentrated in underdeveloped nations, particularly in Africa, where the greatest incidence is seen. The prevailing problems arising from unsafe abortions are incomplete abortions, severe haemorrhaging, and infections. Less often seen but very consequential consequences include septic shock, perforation of abdominal visceral organs, and inflammation of the peritoneum. (Ganatra, Gerdts, Rossier, & Johnson, 2017). Therefore, the study will examine the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
1.3 Objective of the study
The broad objective of the study is to examine the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State. The specific objectives is as follows
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Examines the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
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Assess the effect of unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
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Investigate strategies to reduce unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
1.4 Research Questions
The following questions will further guide the study
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What are the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State?
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What are the effect of unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State?
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What are the strategies to reduce unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State?
1.5 Hypotheses
The hypotheses have been formulated for the study
H0: There are no factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
Ha:There are factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
1.5 Scope of the study
The study focus on the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State. Hence, the study will examines the factors associated with unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State, assess the effect of unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State and investigate strategies to reduce unsafe abortion among young adults (Adolescent) In Eziala Nsulu Community In Isiala Ngwa North, Abia State.
1.6 Significance of the study
The findings of the study is significant to teenagers as it will empower the teenagers with knowledge to change unhealthy attitudes and practices and embrace those recommended for the prevention of unsafe abortions. It will help in knowledge enrichment and as a yard stick of reference and comparison of data obtained elsewhere in Nigeria.
The findings of the study is significant to the academic community as it will contribute to the existing literature.
1.7Justification of the Study
Despite the fact that very many actions have been put in place by the World Health Organization (WHO),and the Ministry of Health, (MOH), to reduce on the cases of unsafe abortions which include improving teenagers access to contraceptives , making most contraceptives free in public health facilities, laws relating to abortions and programs that provide detailed right sex education, the number of abortion cases is still high and there is need to understand the factors influencing teenagers to practice un safe abortions.
Addressing the actors influencing teenagers to practice unsafe abortions in a more effective way will give strong ground for effective intervention to reduce maternal mortality and morbidity.
It will empower the teenagers with knowledge to change unhealthy attitudes and practices and embrace those recommended for the prevention of unsafe abortions.
1.8 Operational Definition of Terms
Unsafe Abortion: the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both.
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