Reasons, Methods Used and Decision-making for Pregnancy Termination Among Adolescents and Older Women in Mulago Hospital, Uganda

Objective: To explore the methods, reasons and decision-making process for termination of pregnancy among adolescents and older women, in Mulago hospital, Kampala, Uganda.

Design: Comparative study.

Subjects: Nine hundred and forty two women seeking postabortion care, of which 333 had induced abortion (of whom 115 were adolescents).

Setting: The emergency gynaecological ward of Mulago Hospital, Kampala, Uganda from September 2003 through June 2004.

Results: Women with induced abortion were single, in polygamous marital relationships and of lower parity (p<0.001); had lower education and number of living children (p<0.05), reported more (p<0.001) mistimed, unplanned or unwanted pregnancies, and were 13 times more likely to have recent history of domestic violence. Relationship issues were the most common reason for pregnancy termination for both categories. Decision-making for induced abortion was influenced by socio-economic, educational and personal considerations. Instrumentation and use of local herbs in the genitalia were the most common methods for pregnancy termination. Neither methods used for pregnancy termination nor reasons differed when adolescents were compared with older women.

Conclusion: Relationship issues influence the decision-making process for pregnancy termination. Neither methods used for pregnancy termination nor reasons for pregnancy termination differ when adolescents are compared with older women.