Characterisation of induced abortion and consequences to women's health at Hospital Central do Huambo – Angola

Abstract

To characterise patients with abortion in Huambo, Angola, we have undertaken a descriptive, longitudinal, prospective survey. A structured questionnaire was applied to 715 patients. The study variables were grouped in socio-demographic and clinical-epidemiological variables. There were 29.8% women were aged 20–24, 45.6% had primary education, 41.1% were single and 26.9% worked as a non-formal salesperson. Menarche occurred at 16–18 years (55.5%), first sexual intercourse at 13–15 years (40.3%) and 74.8% did not use contraceptive methods. Abortion was of indeterminate type in 84.3% and 79.3% had had a previous abortion. Serious complications occurred in 8.0% with six maternal deaths (0.8%). Age of menarche and age at onset of sexual activity are interdependent variables (p ≤ .001), the earlier menarche appears, the earlier sexual activity begins. When there was a history of abortion, new abortions occurred earlier (p ≤ .001) and were of indeterminate type (89%). Indeterminate induced abortion is influenced by socioeconomic, educational and political conditions and continues to be a frequent cause of morbidity and mortality.

Impact statement

• What is already known on this subject? Unsafe abortion contributes greatly to maternal morbidity and mortality, principally in countries with restrictive abortion laws. The relationship between socio-educational level and unwanted pregnancies is consensual.

• What the results of this study add? Early initiation of sexual activity combined with non-contraception contributes to unwanted pregnancy and consequent unsafe abortion. Most of the women had previously had an abortion.

• What the implications are of these findings for clinical practice and/or further research? It is necessary to develop access to adequate information and family planning to combat unwanted pregnancies. It is also important to evaluate long-term consequences of unsafe abortion.

Keywords:

• Illegal abortion
• induced abortion
• abortion
• septic
• abortion complications

Acknowledgements

The authors acknowledge all the technical team of the ‘Hospital Central do Huambo’ who contributed to the study.

Disclosure statement

The authors have no conflicts of interest.

Additional information

Funding

N. Almeida thanks the Angola state funding agency ‘Instituto Nacional de Gestão de Bolsas de Estudo (INAGBE)’ for the inclusion of the project in the scholarship offers for doctoral studies. A. Teixeira is funded by the scholarship 6585/BPD_B3-A/2018 within project ‘NanoSTIMA: Macro-to-Nano Human Sensing: Towards Integrated Multimodal Health Monitoring and Analytics/NORTE-01-0145-FEDER-000016’, financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF).