Objective: Although illegal, abortions in Haiti still occur, the majority of them self-managed and unsafe. Complications from self-managed and unsafe abortions contribute to already-high rates of maternal morbidity and mortality in Haiti. This study aims to examine factors associated with attempt of a self-managed abortion in the context of pregnancy intention and prior pregnancy outcomes to determine potential areas of intervention.
Study Design: This was a secondary analysis of data collected from women (n=263) who presented to Justinien University Hospital in Cap-Haïtien, Haiti from July 2013 - January 2014. Binary logistic regression analyses were run to examine factors associated with pregnancy intention and prior pregnancy outcomes among participants who attempted a self-managed abortion in the current pregnancy, and among those with an ever-attempt of a self-managed abortion.
Results: Women who had completed some secondary school (OR=6.993) and women who had no prenatal visits were more likely to have attempted a self-managed abortion in the current pregnancy as compared to women who completed some primary school or less and women who had one prenatal visit (OR=3.745) or two prenatal visits (OR=4.237). Women who either certain they don’t or unsure if they do want children in the future were more likely to have ever-attempted a self-managed abortion (OR=6.067). Having used any method of family planning up to the current pregnancy was a significant risk factor having ever-attempted a self-managed abortion (OR=9.071). Pregnancy intention was not statistically significant among women who attempted a self-managed abortion in the current pregnancy however, women who characterized their current pregnancy as unintended had higher odds of ever-attempting a self-managed abortion as compared with women who characterized her pregnancy as intended (OR=50.0).
Conclusion: Factors that inform women’s decisions regarding abortion are complex and difficult to parse to fully capture the context surrounding women’s abortion decision-making. Ensuring women have reproductive autonomy to determine the outcome of future pregnancies, control the number and spacing of children, and decide with their provider a suitable contraceptive method consistent with these factors, are critical in reducing maternal morbidity and mortality in Haiti.
Table of Contents
ABBREVIATIONS AND ACRONYMS VIII
CHAPTER I: INTRODUCTION 1
Background and Rationale 1
Problem and Purpose Statement 2
Research Objectives 3
Significance Statement 3
CHAPTER II: COMPREHENSIVE REVIEW OF THE LITERATURE 5
Global Landscape 5
Maternal Mortality 5
Trends of Pregnancy Intention 6
Access to SRH Services and Family Planning 8
Access to Contraception 9
Availability of Safe Abortion Services 11
Maternal Mortality 12
Trends of Pregnancy Intention and Fertility 13
Access to SRH Services and Family Planning 13
Access to Contraception 14
Availability of Safe Abortion Services 16
CHAPTER III: MANUSCRIPT 18
Tables and Figures 50
CHAPTER IV: RECOMMENDATIONS, IMPLICATIONS, AND CONCLUSIONS 54
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Factors Associated with Attempt of Self-Managed Abortion in the Context of Intention and Prior Pregnancy Outcomes in Urban Haiti: A Secondary Analysis of Survey Data from the Justinien University Hospital in Cap-Haïtien ()||2019-04-24 15:21:35 -0400||