TY - JOUR
T1 - Induced abortion incidence and safety in Côte d’Ivoire
AU - Bell, Suzanne O.
AU - Sheehy, Grace
AU - Hyacinthe, Andoh Kouakou
AU - Guiella, Georges
AU - Moreau, Caroline
N1 - Publisher Copyright:
© 2020 Bell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/5
Y1 - 2020/5
N2 - Background In Côte d’Ivoire, induced abortion is legally restricted unless a pregnancy threatens a woman’s life. Yet the limited available evidence suggests abortion is common and that unsafe abortion is contributing to the country’s high maternal mortality. Our study aimed to estimate the one-year incidence of induced abortion in Côte d’Ivoire using both direct and indirect methodologies, determine the safety of reported abortions, and identify the women most likely to experience a recent induced abortion or an unsafe abortion. Methods In 2018, we conducted a nationally representative, population-based survey of women age 15 to 49 in Côte d’Ivoire. Women reported their own abortion experiences and those of their closest female confidante. We estimated the one-year incidence of induced abortion, and the safety of the abortions women experienced. Using bivariate and multivariate regression, we separately assessed sociodemographic characteristics associated with having had a recent abortion or an unsafe abortion. Results Overall, 2,738 women participated in the survey, approximately two-thirds of whom reported on the abortion experiences of their closest female friend. Based on respondent data, the one-year incidence of induced abortion was 27.9 (95% CI 18.6–37.1) per 1,000 women of reproductive age, while the confidante incidence was higher at 40.7 (95% CI 33.3–48.1) per 1,000. Among respondents, 62.4% of abortions were most unsafe, while 78.5% of confidante abortions were most unsafe. Adolescents, less educated women, and the poorest women had the most unsafe abortions. Conclusion This study provides the first national estimates of induced abortion incidence and safety in Côte d’Ivoire, using a population-based approach to explore social determinants of abortion and unsafe abortion. Consistent with other research, our results suggest that legal restrictions on abortion in Côte d’Ivoire are not preventing women from having abortions, but rather pushing women to use unsafe, potentially dangerous abortion methods. Efforts to reduce the harms of unsafe abortion are urgently needed.
AB - Background In Côte d’Ivoire, induced abortion is legally restricted unless a pregnancy threatens a woman’s life. Yet the limited available evidence suggests abortion is common and that unsafe abortion is contributing to the country’s high maternal mortality. Our study aimed to estimate the one-year incidence of induced abortion in Côte d’Ivoire using both direct and indirect methodologies, determine the safety of reported abortions, and identify the women most likely to experience a recent induced abortion or an unsafe abortion. Methods In 2018, we conducted a nationally representative, population-based survey of women age 15 to 49 in Côte d’Ivoire. Women reported their own abortion experiences and those of their closest female confidante. We estimated the one-year incidence of induced abortion, and the safety of the abortions women experienced. Using bivariate and multivariate regression, we separately assessed sociodemographic characteristics associated with having had a recent abortion or an unsafe abortion. Results Overall, 2,738 women participated in the survey, approximately two-thirds of whom reported on the abortion experiences of their closest female friend. Based on respondent data, the one-year incidence of induced abortion was 27.9 (95% CI 18.6–37.1) per 1,000 women of reproductive age, while the confidante incidence was higher at 40.7 (95% CI 33.3–48.1) per 1,000. Among respondents, 62.4% of abortions were most unsafe, while 78.5% of confidante abortions were most unsafe. Adolescents, less educated women, and the poorest women had the most unsafe abortions. Conclusion This study provides the first national estimates of induced abortion incidence and safety in Côte d’Ivoire, using a population-based approach to explore social determinants of abortion and unsafe abortion. Consistent with other research, our results suggest that legal restrictions on abortion in Côte d’Ivoire are not preventing women from having abortions, but rather pushing women to use unsafe, potentially dangerous abortion methods. Efforts to reduce the harms of unsafe abortion are urgently needed.
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U2 - 10.1371/journal.pone.0232364
DO - 10.1371/journal.pone.0232364
M3 - Article
C2 - 32379768
AN - SCOPUS:85084320110
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 5
M1 - e0232364
ER -