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Published in: Reproductive Health 1/2019

Open Access 01-12-2019 | Research

Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

Authors: Daniel Katuashi Ishoso, Antoinette Kitoto Tshefu, Thérèse Delvaux, Yves Coppieters

Published in: Reproductive Health | Issue 1/2019

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Abstract

Background

Due to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the extent of induced abortions and occurrence of complications in Kinshasa.

Methodology

This cross-sectional study was conducted with a sample of 460 women who were interviewed about their experiences as females, and provided information of 1444 women of childbearing age living in Kinshasa. Respondents’ households were selected to represent the five types of residential quarters in Kinshasa, differentiated by cultural, socioeconomic, and infrastructural characteristics. Information was collected using a survey form and analyzed.

Results

Among all confidantes included in the study, 5.5% (95% CI: 4.4–6.8%) had induced abortions during 2015, a rate of 55.0 abortions per 1000 women of childbearing age. This practice was significantly performed amongst single/separated/divorced women; those without formal education, or primary-school education, and women who consumed excessive alcohol. Most abortions were induced by the administration of high doses of medication, by the women themselves or by health workers. A percentage of 51.9% (95%CI: 40.4–63.3%) of induced abortions led to complications, which were predominantly haemorrhagic. Moreover, 39% of patients had a complication for which they sought care, and of whom 12.5% had genital trauma or uterine perforation/intestinal necrosis.

Conclusion

Induced abortion is a public health problem in Kinshasa due to its frequency of practice, the complications that occur, and the absence of major surgeries in the health care package offered by the health centres or dispensaries that also provide the treatment of some serious complications. Thus, there is a need to focus on the enhancement of the health care package offered by health centres to include appropriate measures in favour of maternal health.
Literature
3.
go back to reference Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.CrossRef Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.CrossRef
4.
go back to reference Thorp JM, Hartmann KE, Shadigian E. Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obstet Gynecol Surv. 2003;58(1):67–79.CrossRef Thorp JM, Hartmann KE, Shadigian E. Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obstet Gynecol Surv. 2003;58(1):67–79.CrossRef
5.
go back to reference Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, Boulot P, Fresson J, Arnaud C, Subtil D, Marpeau L, Rozé JC, Maillard F, Larroque B. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. EPIPAGE Group BJOG. 2005;112(4):430–7.CrossRef Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, Boulot P, Fresson J, Arnaud C, Subtil D, Marpeau L, Rozé JC, Maillard F, Larroque B. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. EPIPAGE Group BJOG. 2005;112(4):430–7.CrossRef
6.
go back to reference Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, Gramzow RH. Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000;57(8):777–84.CrossRef Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, Gramzow RH. Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000;57(8):777–84.CrossRef
7.
go back to reference De Tourris H., Henrion R., Delecour M. Abrégé de Gymécologie et obstétrique. 6ème édition. Paris Milan Barcelone: Masson 1994: 671. De Tourris H., Henrion R., Delecour M. Abrégé de Gymécologie et obstétrique. 6ème édition. Paris Milan Barcelone: Masson 1994: 671.
8.
go back to reference Singh S, Prada E, Juarez F, The abortion incidence complications method: a quantitative technique, dans: Singh S, Remez L et Tartaglione A, eds., Methodologies for Estimating Abortion Incidence and Abortion-Related Morbidity: A Review, New York: Guttmacher institute; et Paris: International Union for the Scientific Study of Population, 2010, pp. 71–98. Singh S, Prada E, Juarez F, The abortion incidence complications method: a quantitative technique, dans: Singh S, Remez L et Tartaglione A, eds., Methodologies for Estimating Abortion Incidence and Abortion-Related Morbidity: A Review, New York: Guttmacher institute; et Paris: International Union for the Scientific Study of Population, 2010, pp. 71–98.
9.
go back to reference Rossier C. The anonymous third party reporting method. In: Singh S, Remez L, Tartiglione A, editors. Methodologies for estimating abortion incidence and abortion-related morbidity: a review. New York and Paris: Guttmacher institute and IUSSP; 2010. p. 99–106. Rossier C. The anonymous third party reporting method. In: Singh S, Remez L, Tartiglione A, editors. Methodologies for estimating abortion incidence and abortion-related morbidity: a review. New York and Paris: Guttmacher institute and IUSSP; 2010. p. 99–106.
10.
go back to reference Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP), ICF International. Enquête démographique et de santé en République Démocratique du Congo 2013–2014. Rockville: MPSMRM, MSP, and ICF International; 2014. Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP), ICF International. Enquête démographique et de santé en République Démocratique du Congo 2013–2014. Rockville: MPSMRM, MSP, and ICF International; 2014.
11.
go back to reference Ibrahim IA, Onwudiegwu U. Sociodemographic determinants of complicated unsafe abortions in a semi-urban Nigerian town: a four-year review. West Indian Med J. 2012;61(2):163–7.PubMed Ibrahim IA, Onwudiegwu U. Sociodemographic determinants of complicated unsafe abortions in a semi-urban Nigerian town: a four-year review. West Indian Med J. 2012;61(2):163–7.PubMed
12.
go back to reference Ekanem EI, Etuk SJ, Ekabua JE, Iklaki C. Clinical presentation and complications in patients with unsafe abortions in University of Calabar Teaching Hospital, Calabar, Nigeria. Niger J Med. 2009;18(4):370–4.PubMed Ekanem EI, Etuk SJ, Ekabua JE, Iklaki C. Clinical presentation and complications in patients with unsafe abortions in University of Calabar Teaching Hospital, Calabar, Nigeria. Niger J Med. 2009;18(4):370–4.PubMed
13.
go back to reference Kinoti SN, Gaffikin L, Benson J. How research can affect policy and programme advocacy: example from a three-country study on abortion complications in sub-Saharan Africa. East Afr Med J. 2004;81(2):63–70.CrossRef Kinoti SN, Gaffikin L, Benson J. How research can affect policy and programme advocacy: example from a three-country study on abortion complications in sub-Saharan Africa. East Afr Med J. 2004;81(2):63–70.CrossRef
14.
go back to reference Sedgh G, Rossier C, Kaboré I, Bankole A, Mikulich M. Estimating abortion incidence in Burkina Faso using two methodologies. Stud Fam Plan. 2011;42(3):147–54.CrossRef Sedgh G, Rossier C, Kaboré I, Bankole A, Mikulich M. Estimating abortion incidence in Burkina Faso using two methodologies. Stud Fam Plan. 2011;42(3):147–54.CrossRef
15.
go back to reference Rossier C, Guiella G, Ouédraogo A, Thiéba B. Estimating clandestine abortion with the confidants method--results from Ouagadougou, Burkina Faso. Soc Sci Med. 2006;62(1):254–66.CrossRef Rossier C, Guiella G, Ouédraogo A, Thiéba B. Estimating clandestine abortion with the confidants method--results from Ouagadougou, Burkina Faso. Soc Sci Med. 2006;62(1):254–66.CrossRef
16.
go back to reference Lelo NF, Tshimanga MC. Pauvreté urbaine à Kinshasa. Kinshasa: Edition Cordaid; 2004. p. 41–4. Lelo NF, Tshimanga MC. Pauvreté urbaine à Kinshasa. Kinshasa: Edition Cordaid; 2004. p. 41–4.
17.
go back to reference Organisation Mondiale de la Santé. Santé des adolescentes: Risques sanitaires et solutions. Rapport final. Genève: OMS; 2016. Organisation Mondiale de la Santé. Santé des adolescentes: Risques sanitaires et solutions. Rapport final. Genève: OMS; 2016.
18.
go back to reference Wilhelm M. Echantillonnage boule de neige : La méthode de sondage déterminé par les répondants. Neuchâtel: Office fédéral de la statistique (OFS); 2014. Wilhelm M. Echantillonnage boule de neige : La méthode de sondage déterminé par les répondants. Neuchâtel: Office fédéral de la statistique (OFS); 2014.
19.
go back to reference Organisation Mondiale de la Santé. Santé sexuelle et reproductive : Promouvoir la planification familiale. Rapport final. Genève: OMS; 2015. Organisation Mondiale de la Santé. Santé sexuelle et reproductive : Promouvoir la planification familiale. Rapport final. Genève: OMS; 2015.
20.
go back to reference Donna C, Toshiko K. Fiche de données sur la planification familiale dans le monde. Washington, DC: Population Reference Bureau; 2013. Donna C, Toshiko K. Fiche de données sur la planification familiale dans le monde. Washington, DC: Population Reference Bureau; 2013.
21.
go back to reference Mbutiwi IN, Lepira BF, Dramaix WM, Meert P, Malengreau M, Nseka MN, Muanda TF, Koné D. L’automédication chez des patients reçus aux urgences médicales des cliniques universitaires de Kinshasa. Santé Publique. 2013;25:233–40.CrossRef Mbutiwi IN, Lepira BF, Dramaix WM, Meert P, Malengreau M, Nseka MN, Muanda TF, Koné D. L’automédication chez des patients reçus aux urgences médicales des cliniques universitaires de Kinshasa. Santé Publique. 2013;25:233–40.CrossRef
22.
go back to reference Coppieters Y, Bivort P, Madani K, Metboul M. Analyse des facteurs de la mortalité maternelle dans le sud algérien. Santé publique 2011, 23, n°5, pp.413–426. Coppieters Y, Bivort P, Madani K, Metboul M. Analyse des facteurs de la mortalité maternelle dans le sud algérien. Santé publique 2011, 23, n°5, pp.413–426.
23.
go back to reference Manzambi JK, Tellier V, Bertrand F, Albert A, Reginster JY, Van BH. Les déterminants du comportement de recours au centre de santé en milieu urbain africain: résultats d’une enquête de ménage menée à Kinshasa, Congo. Tropical Med Int Health. 2000;5(8):563–70.CrossRef Manzambi JK, Tellier V, Bertrand F, Albert A, Reginster JY, Van BH. Les déterminants du comportement de recours au centre de santé en milieu urbain africain: résultats d’une enquête de ménage menée à Kinshasa, Congo. Tropical Med Int Health. 2000;5(8):563–70.CrossRef
24.
go back to reference Kigbu JH, Daru PH, Ujah IA. Review of maternal deaths from unsafe abortion in Jos, Nigeria. Niger J Med. 2009;18(1):103–6.PubMed Kigbu JH, Daru PH, Ujah IA. Review of maternal deaths from unsafe abortion in Jos, Nigeria. Niger J Med. 2009;18(1):103–6.PubMed
25.
go back to reference Abiodun OM, Balogun OR, Adeleke NA, Farinloye EO. Complications of unsafe abortion in south West Nigeria: a review of 96 cases. Afr J Med Med Sci. 2013;42(1):111–5.PubMed Abiodun OM, Balogun OR, Adeleke NA, Farinloye EO. Complications of unsafe abortion in south West Nigeria: a review of 96 cases. Afr J Med Med Sci. 2013;42(1):111–5.PubMed
26.
go back to reference Mitsunaga TM, Larsen UM, Okonofua FE. Risk factors for complications of induced abortions in Nigeria. J Women's Health (Larchmt). 2005;14(6):515–28.CrossRef Mitsunaga TM, Larsen UM, Okonofua FE. Risk factors for complications of induced abortions in Nigeria. J Women's Health (Larchmt). 2005;14(6):515–28.CrossRef
27.
go back to reference Bernabé-Ortiz A, White PJ, Carcamo CP, Hughes JP, Gonzales MA, Garcia PJ, Garnett GP, Holmes KK. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country. CMAJ. 2009;180(3):298–304 Erratum in: CMAJ. 2009; 3; 180(5):541.CrossRef Bernabé-Ortiz A, White PJ, Carcamo CP, Hughes JP, Gonzales MA, Garcia PJ, Garnett GP, Holmes KK. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country. CMAJ. 2009;180(3):298–304 Erratum in: CMAJ. 2009; 3; 180(5):541.CrossRef
28.
go back to reference Levandowski BA, Pearson E, Lunguzi J, Katengeza HR. Reproductive health characteristics of young Malawian women seeking post-abortion care. Afr J Reprod Health. 2012;16(2):253–61.PubMed Levandowski BA, Pearson E, Lunguzi J, Katengeza HR. Reproductive health characteristics of young Malawian women seeking post-abortion care. Afr J Reprod Health. 2012;16(2):253–61.PubMed
29.
go back to reference Bankole A, Hussain R, Sedgh G, Rossier C, Kaboré I, Guiella G. Grossesse non désirée et avortement provoqué au Burkina Faso: causes et conséquences. NewYork: Guttmacher Institute; 2013. Bankole A, Hussain R, Sedgh G, Rossier C, Kaboré I, Guiella G. Grossesse non désirée et avortement provoqué au Burkina Faso: causes et conséquences. NewYork: Guttmacher Institute; 2013.
30.
go back to reference Basinga P, Moore A, Singh S, Remez L, Birungi F, Nyirazinyoye L. Unintended pregnancy and induced abortion in Rwanda: causes and consequences. New York: Guttmacher Institute; 2013. Basinga P, Moore A, Singh S, Remez L, Birungi F, Nyirazinyoye L. Unintended pregnancy and induced abortion in Rwanda: causes and consequences. New York: Guttmacher Institute; 2013.
31.
go back to reference Dragoman M, Sheldon WR, Qureshi Z, Blum J, Winikoff B, Ganatra B. WHO multicountry survey on maternal newborn Health Research network. Overview of abortion cases with severe maternal outcomes in the WHO multicountry survey on maternal and newborn health: a descriptive analysis. BJOG. 2014;121(Suppl 1):25–31.CrossRef Dragoman M, Sheldon WR, Qureshi Z, Blum J, Winikoff B, Ganatra B. WHO multicountry survey on maternal newborn Health Research network. Overview of abortion cases with severe maternal outcomes in the WHO multicountry survey on maternal and newborn health: a descriptive analysis. BJOG. 2014;121(Suppl 1):25–31.CrossRef
32.
go back to reference World Health Organization. Unsafe abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2008. 6th ed. Geneva: WHO; 2011. World Health Organization. Unsafe abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2008. 6th ed. Geneva: WHO; 2011.
33.
go back to reference Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH. Unsafe abortion: the preventable pandemic. Lancet. 2006;368(9550):1908–19.CrossRef Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH. Unsafe abortion: the preventable pandemic. Lancet. 2006;368(9550):1908–19.CrossRef
34.
go back to reference Programme des Nations Unies pour le Développement. Unité de lutte contre la pauvreté. Rapport final sur la pauvreté et les conditions de vie des ménages de Kinshasa. In: Kinshasa; 2009. Programme des Nations Unies pour le Développement. Unité de lutte contre la pauvreté. Rapport final sur la pauvreté et les conditions de vie des ménages de Kinshasa. In: Kinshasa; 2009.
Metadata
Title
Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo
Authors
Daniel Katuashi Ishoso
Antoinette Kitoto Tshefu
Thérèse Delvaux
Yves Coppieters
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2019
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-019-0727-4

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