International Journal of Environmental Research and Public Health

Editorial

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4 pages, 233 KiB

Open AccessEditorial

Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility

by Jon Øyvind Odland

Int. J. Environ. Res. Public Health 2018, 15(6), 1176; https://doi.org/10.3390/ijerph15061176 - 5 Jun 2018

Cited by 3 | Viewed by 4459

Abstract

We are proud to present 14 papers with focus on teenager health in this Special Issue entitled “Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility”. [...] Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

Research

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17 pages, 336 KiB

Open AccessArticle

Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal

by Bimala Sharma and Eun Woo Nam

Int. J. Environ. Res. Public Health 2018, 15(3), 535; https://doi.org/10.3390/ijerph15030535 - 16 Mar 2018

Cited by 11 | Viewed by 7457

Abstract

This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents [...] Read more.

This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

15 pages, 293 KiB

Open AccessArticle

Young Women’s Perspectives of Their Adolescent Treatment Programs: A Qualitative Study

by Miriam Clark, Rohanna Buchanan and Leslie D. Leve

Int. J. Environ. Res. Public Health 2018, 15(2), 373; https://doi.org/10.3390/ijerph15020373 - 22 Feb 2018

Cited by 5 | Viewed by 4376

Abstract

The perspectives of at-risk adolescent clients can play an important role in informing treatment services. The current study examines qualitative interview data from 15 young women with histories of maltreatment. Using a semi-structured qualitative interview approach, we asked the women to think retrospectively [...] Read more.

The perspectives of at-risk adolescent clients can play an important role in informing treatment services. The current study examines qualitative interview data from 15 young women with histories of maltreatment. Using a semi-structured qualitative interview approach, we asked the women to think retrospectively about their treatment experiences as adolescent girls. Results highlight the need for providing adolescent girls with reliable and practical information about risky sexual behavior and drug use from relatable and trustworthy helping professionals. We discuss strategies for developing and maintaining trust and delivering specific content. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

10 pages, 291 KiB

Open AccessArticle

Adolescents’ Sexual Wellbeing in Southwestern Uganda: A Cross-Sectional Assessment of Body Image, Self-Esteem and Gender Equitable Norms

by Elizabeth Kemigisha, Viola N. Nyakato, Katharine Bruce, Gad Ndaruhutse Ruzaaza, Wendo Mlahagwa, Anna B. Ninsiima, Gily Coene, Els Leye and Kristien Michielsen

Int. J. Environ. Res. Public Health 2018, 15(2), 372; https://doi.org/10.3390/ijerph15020372 - 22 Feb 2018

Cited by 19 | Viewed by 5745

Abstract

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its [...] Read more.

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its broad sense—i.e., body image, self-esteem, and gender equitable norms—and associated factors in young adolescents in Uganda. A cross-sectional survey of adolescents ages 10–14 years in schools was carried out between June and July 2016. Among 1096 adolescents analyzed, the median age was 12 (Inter-Quartile Range (IQR): 11, 13) and 58% were female. Self-esteem and body image scores were high with median 24 (IQR: 22, 26, possible range: 7–28) and median 22 (IQR: 19, 24, possible range: 5–25) respectively. Gender equitable norms mean score was 28.1 (SD 5.2: possible range 11–44). We noted high scores for self-esteem and body image but moderate scores on gender equitable norms. Girls had higher scores compared to boys for all outcomes. A higher age and being sexually active were associated with lower scores on gender equitable norms. Gender equitable norms scores decreased with increasing age of adolescents. Comprehensive and timely sexuality education programs focusing on gender differences and norms are recommended. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

9 pages, 591 KiB

Open AccessArticle

The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi

by Maria Lisa Odland, Gladys Membe-Gadama, Ursula Kafulafula, Geir W. Jacobsen, James Kumwenda and Elisabeth Darj

Int. J. Environ. Res. Public Health 2018, 15(2), 370; https://doi.org/10.3390/ijerph15020370 - 21 Feb 2018

Cited by 16 | Viewed by 7835

Abstract

Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to [...] Read more.

Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7–12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

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18 pages, 330 KiB

Open AccessArticle

Ten Years of Experience in Contraception Options for Teenagers in a Family Planning Center in Thrace and Review of the Literature

by Panagiotis Tsikouras, Dorelia Deuteraiou, Anastasia Bothou, Xanthi Anthoulaki, Anna Chalkidou, Eleftherios Chatzimichael, Fotini Gaitatzi, Bachar Manav, Zacharoula Koukouli, Stefanos Zervoudis, Grigorios Trypsianis and George Galazios

Int. J. Environ. Res. Public Health 2018, 15(2), 348; https://doi.org/10.3390/ijerph15020348 - 15 Feb 2018

Cited by 5 | Viewed by 5735

Abstract

Introduction: The goal of our study was to investigate and evaluate the contraceptive behavior in teenagers from our family planning centre that services two different religious and socioeconomic populations living in the Thrace area. Methods: During the last 10 years 115 [...] Read more.

Introduction: The goal of our study was to investigate and evaluate the contraceptive behavior in teenagers from our family planning centre that services two different religious and socioeconomic populations living in the Thrace area. Methods: During the last 10 years 115 Christian Orthodox (group A) and 53 Muslim teenagers (group B) were enrolled in our retrospective study. Contraceptive practice attitudes were assessed by a questionnaire. Religion, demographics, socio-economic characteristics were key factors used to discuss contraception and avoid unplanned pregnancy in each group and to compare with the contraceptive method used. Results: The most used contraceptive method—about two times more frequently—among Christian Orthodox participants was the oral contraceptive pill (p = 0.015; OR = 1.81, 95% CI = 1.13–2.90), while in the other group the use of condoms and IUDs was seven and three times more frequent, respectively. Our family planning centre was the main source of information for contraception. Conclusions: During adolescence, the existence of a family planning centre and participation in family planning programs plays a crucial role to help the teenagers to improve their knowledge and choose an effective contraception method. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

13 pages, 729 KiB

Open AccessArticle

Factors Influencing Abortion Decision-Making Processes among Young Women

by Mónica Frederico, Kristien Michielsen, Carlos Arnaldo and Peter Decat

Int. J. Environ. Res. Public Health 2018, 15(2), 329; https://doi.org/10.3390/ijerph15020329 - 13 Feb 2018

Cited by 48 | Viewed by 19578

Abstract

Background: Decision-making about if and how to terminate a pregnancy is a dilemma for young women experiencing an unwanted pregnancy. Those women are subject to sociocultural and economic barriers that limit their autonomy and make them vulnerable to pressures that influence or force [...] Read more.

Background: Decision-making about if and how to terminate a pregnancy is a dilemma for young women experiencing an unwanted pregnancy. Those women are subject to sociocultural and economic barriers that limit their autonomy and make them vulnerable to pressures that influence or force decisions about abortion. Objective: The objective of this study was to explore the individual, interpersonal and environmental factors behind the abortion decision-making process among young Mozambican women. Methods: A qualitative study was conducted in Maputo and Quelimane. Participants were identified during a cross-sectional survey with women in the reproductive age (15–49). In total, 14 women aged 15 to 24 who had had an abortion participated in in-depth interviews. A thematic analysis was used. Results: The study found determinants at different levels, including the low degree of autonomy for women, the limited availability of health facilities providing abortion services and a lack of patient-centeredness of health services. Conclusions: Based on the results of the study, the authors suggest strategies to increase knowledge of abortion rights and services and to improve the quality and accessibility of abortion services in Mozambique. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

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11 pages, 295 KiB

Open AccessArticle

Are Kazakhstani Women Satisfied with Antenatal Care? Implementing the WHO Tool to Assess the Quality of Antenatal Services

by Marzhan A. Dauletyarova, Yuliya M. Semenova, Galiya Kaylubaeva, Gulshat K. Manabaeva, Bakytkul Toktabayeva, Maryash S. Zhelpakova, Oxana A. Yurkovskaya, Aidos S. Tlemissov, Galina Antonova and Andrej M. Grjibovski

Int. J. Environ. Res. Public Health 2018, 15(2), 325; https://doi.org/10.3390/ijerph15020325 - 13 Feb 2018

Cited by 31 | Viewed by 4714

Abstract

Women’s satisfaction is a part of the quality assurance process with potential to improve antenatal health services. The objective of this study was to assess the prevalence of women’s satisfaction with antenatal care in an urban Kazakhstani setting and investigate associated factors. A [...] Read more.

Women’s satisfaction is a part of the quality assurance process with potential to improve antenatal health services. The objective of this study was to assess the prevalence of women’s satisfaction with antenatal care in an urban Kazakhstani setting and investigate associated factors. A total of 1496 women who delivered in all maternity clinics from 6 February through 11 July 2013 in Semey, East Kazakhstan, filled out a standardized pretested questionnaire on satisfaction with antenatal care. Independent associations between dissatisfaction and its correlates were studied by logistic regression. Ninety percent of the women were satisfied with the antenatal care. Women who were dissatisfied had lower education. These women would have preferred more checkups, shorter intervals between checkups, more time with care providers, and shorter waiting times. The overall dissatisfaction was associated with long waiting times and insufficient information on general health in pregnancy, results of laboratory tests, treatment during pregnancy, and breastfeeding. Although most of the women in the study setting were satisfied with the new antenatal care model, we identified the main sources of dissatisfaction that should be addressed. Given that Semey is a typical Kazakhstani city, the results can be generalized to other Kazakhstani urban settings. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

12 pages, 561 KiB

Open AccessArticle

“I Was Relieved to Know That My Baby Was Safe”: Women’s Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania

by Sara Rivenes Lafontan, Johanne Sundby, Hege L. Ersdal, Muzdalifat Abeid, Hussein L. Kidanto and Columba K. Mbekenga

Int. J. Environ. Res. Public Health 2018, 15(2), 302; https://doi.org/10.3390/ijerph15020302 - 9 Feb 2018

Cited by 22 | Viewed by 6349

Abstract

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this [...] Read more.

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in Tanzania. A thematic content analysis was used to analyze the data. Our results indicated that the use of the monitor positively affected the women’s birth experience. It provided much-needed reassurance about the wellbeing of the child. The women considered that wearing Moyo improved care due to an increase in communication and attention from birth attendants. However, the women did not fully understand the purpose and function of the device and overestimated its capabilities. This highlights the need to improve how and when information is conveyed to women in labor. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

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12 pages, 334 KiB

Open AccessFeature PaperArticle

Adverse Pregnancy Outcomes among Adolescents in Northwest Russia: A Population Registry-Based Study

by Anna A. Usynina, Vitaly Postoev, Jon Øyvind Odland and Andrej M. Grjibovski

Int. J. Environ. Res. Public Health 2018, 15(2), 261; https://doi.org/10.3390/ijerph15020261 - 3 Feb 2018

Cited by 18 | Viewed by 5260

Abstract

This study aimed to assess whether adolescents have an increased risk of adverse pregnancy outcomes (APO) compared to adult women. We used data on 43,327 births from the population-based Arkhangelsk County Birth Registry, Northwest Russia, for 2012–2014. The perinatal outcomes included stillbirth, preterm [...] Read more.

This study aimed to assess whether adolescents have an increased risk of adverse pregnancy outcomes (APO) compared to adult women. We used data on 43,327 births from the population-based Arkhangelsk County Birth Registry, Northwest Russia, for 2012–2014. The perinatal outcomes included stillbirth, preterm birth (<37 and <32 weeks), low and very low birthweight, 5 min Apgar score <7 and <4, perinatal infections, and the need for neonatal transfer to a higher-level hospital. Multivariable logistic regression was applied to assess the associations between age and APO. Altogether, 4.7% of deliveries occurred in adolescents. Both folic acid intake and multivitamin intake during pregnancy were more prevalent in adults. Adolescents were more likely to be underweight, to smoke, and to have infections of the kidney and the genital tract compared to adult women. Compared to adults, adolescents were at lower risk of low birthweight, a 5 min Apgar score <7, and need for neonatal transfer. Adolescents had no increased risk of other APO studied in the adjusted analysis, suggesting that a constellation of other factors, but not young age per se, is associated with APO in the study setting. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

12 pages, 270 KiB

Open AccessArticle

Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011

by Rina Pradhan, Karen Wynter and Jane Fisher

Int. J. Environ. Res. Public Health 2018, 15(2), 229; https://doi.org/10.3390/ijerph15020229 - 30 Jan 2018

Cited by 13 | Viewed by 5273

Abstract

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, [...] Read more.

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

16 pages, 297 KiB

Open AccessArticle

“Girls Have More Challenges; They Need to Be Locked Up”: A Qualitative Study of Gender Norms and the Sexuality of Young Adolescents in Uganda

by Anna B. Ninsiima, Els Leye, Kristien Michielsen, Elizabeth Kemigisha, Viola N. Nyakato and Gily Coene

Int. J. Environ. Res. Public Health 2018, 15(2), 193; https://doi.org/10.3390/ijerph15020193 - 24 Jan 2018

Cited by 69 | Viewed by 9348

Abstract

Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives [...] Read more.

Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives of young girls. This study explores the social construction of gender norms from early childhood, and how it influences adolescents’ agency. Contrary to the mainstream theory of agency, which focuses on the ability to make informed choices, adolescents’ agency appears constrained by context-specific obstacles. This study adopted qualitative research approaches involving 132 participants. Of these, 44 were in-depth interviews and 11 were focus group discussions, parcelled out into separate groups of adolescents (12–14 years), teachers, and parents (n = 88), in Western Uganda. Data were analysed manually using open and axial codes, and conclusions were inductive. Results show that gender norms are established early in life, and have a very substantial impact on the agency of young adolescents. There were stereotypical gender norms depicting boys as sexually active and girls as restrained; girls’ movements were restricted; their sexual agency constrained; and prevention of pregnancy was perceived as a girl’s responsibility. Programs targeting behavioural change need to begin early in the lives of young children. They should target teachers and parents about the values of gender equality and strengthen the legal system to create an enabling environment to address the health and wellbeing of adolescents. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

14 pages, 327 KiB

Open AccessArticle

STI Knowledge in Berlin Adolescents

by Frederik Tilmann Von Rosen, Antonella Juline Von Rosen, Falk Müller-Riemenschneider, Inken Damberg and Peter Tinnemann

Int. J. Environ. Res. Public Health 2018, 15(1), 110; https://doi.org/10.3390/ijerph15010110 - 10 Jan 2018

Cited by 36 | Viewed by 6636

Abstract

Sexually transmitted infections (STIs) pose a significant threat to individual and public health. They disproportionately affect adolescents and young adults. In a cross-sectional study, we assessed self-rated and factual STI knowledge in a sample of 9th graders in 13 secondary schools in Berlin, [...] Read more.

Sexually transmitted infections (STIs) pose a significant threat to individual and public health. They disproportionately affect adolescents and young adults. In a cross-sectional study, we assessed self-rated and factual STI knowledge in a sample of 9th graders in 13 secondary schools in Berlin, Germany. Differences by age, gender, migrant background, and school type were quantified using bivariate and multivariable analyses. A total of 1177 students in 61 classes participated. The mean age was 14.6 (SD = 0.7), 47.5% were female, and 52.9% had at least one immigrant parent. Knowledge of human immunodeficiency virus (HIV) was widespread, but other STIs were less known. For example, 46.2% had never heard of chlamydia, 10.8% knew of the HPV vaccination, and only 2.2% were aware that no cure exists for HPV infection. While boys were more likely to describe their knowledge as good, there was no general gender superiority in factual knowledge. Children of immigrants and students in the least academic schools had lower knowledge overall. Our results show that despite their particular risk to contract an STI, adolescents suffer from suboptimal levels of knowledge on STIs beyond HIV. Urgent efforts needed to improve adolescent STI knowledge in order to improve the uptake of primary and secondary prevention. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

14 pages, 292 KiB

Open AccessArticle

Parents’ Perspectives on Family Sexuality Communication from Middle School to High School

by Jennifer M. Grossman, Lisa J. Jenkins and Amanda M. Richer

Int. J. Environ. Res. Public Health 2018, 15(1), 107; https://doi.org/10.3390/ijerph15010107 - 10 Jan 2018

Cited by 43 | Viewed by 10023

Abstract

Parents’ conversations with teens about sex and relationships can play a critical role in improving teenage reproductive health by reducing teens’ risky sexual behavior. However, little is known about how teen-parent communication changes from early to middle adolescence and how parents can tailor [...] Read more.

Parents’ conversations with teens about sex and relationships can play a critical role in improving teenage reproductive health by reducing teens’ risky sexual behavior. However, little is known about how teen-parent communication changes from early to middle adolescence and how parents can tailor their communication to address their teens’ changing development and experiences during these periods. In this longitudinal qualitative study, U.S. parents (N = 23) participated in interviews when their teens were in early adolescence, then again when the teens were in middle adolescence. Participants were largely mothers and were from diverse racial/ethnic and educational backgrounds. Thematic analysis was used to assess continuity and change in parents’ perceptions of teen-parent communication. Findings showed that many parents adapted their conversations with their teens about sex and relationships as teens developed. Once teens had entered high school, more parents described feeling comfortable with their conversations. However, parents also more often reported that their teens responded negatively to the communication in high school than they had in middle school. These findings may help parents to anticipate their own as well as their teens’ responses to family conversations about sex at different developmental time points and to strategize how to effectively talk with their teens about sex and relationships to improve their teens’ overall reproductive health. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

277 KiB

Open AccessFeature PaperArticle

“I Am Ready and Willing to Provide the Service … Though My Religion Frowns on Abortion”—Ghanaian Midwives’ Mixed Attitudes to Abortion Services: A Qualitative Study

by Prince Oppong-Darko, Kwame Amponsa-Achiano and Elisabeth Darj

Int. J. Environ. Res. Public Health 2017, 14(12), 1501; https://doi.org/10.3390/ijerph14121501 - 4 Dec 2017

Cited by 21 | Viewed by 8159

Abstract

Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective: [...] Read more.

Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective: The aim of the study was to understand midwives’ readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. Methods: A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Results: Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana’s abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. Conclusion: The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy. Full article

(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)

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