Unsafe Abortion a Major Cause of Maternal Death in Ghana

Lack of Awareness of Abortion Law Is a Barrier to Better Health

More than one in 10 pregnancy-related deaths in Ghana are the result of unsafe abortions. In addition, 13% of Ghanaian women who have had an abortion experience complications resulting from unsafe procedures, and fewer than half of them received the needed follow-up care. These statistics are all the more remarkable because Ghana is one of the few African countries where abortion is legal under fairly broad grounds, and abortion performed by a qualified professional under proper conditions is an extremely safe procedure.

"Abortion in Ghana," a new report released today by the New York-based Guttmacher Institute brings together data from various studies, including the 2007 Ghana Maternal Health Survey (GMHS), to present what is known about abortion in Ghana, including information on incidence, abortion providers and the procedures they use, and the characteristics of women having abortions.

A major factor contributing to unsafe abortion in Ghana is that only 4% of women surveyed in 2007 were aware that abortion is legal under fairly broad grounds. Unaware that they can legally obtain a safe abortion procedure, many women turn to unsafe providers. Women also face other barriers to accessing safe abortion services, including high cost, a limited number of qualified abortion providers and concerns about social stigma.

According to the 2007 GMHS survey, at least 7% of all pregnancies in Ghana end in abortion, and 15% of women aged 15–49 admitted to having had an abortion. Abortion rates were highest among 20–24-year-olds, educated and wealthier women, and those living in urban areas. According to the same survey, just over half of the women (57%) who admitted that they had had an abortion sought a doctor to perform the procedure, while most others turned to pharmacists or traditional midwives to induce abortion. Almost one in five women induced the abortion themselves or had the help of a friend. The most common reason women sought an abortion was not having the financial means to take care of a child. Other frequently reported reasons included wanting to delay childbearing or complete school.

"That so many Ghanaian women are killed or injured by unsafe abortion is all the more tragic because it is unnecessary," says Gilda Sedgh, senior research associate at the Guttmacher Institute and author of the report. "Efforts to increase awareness of the law, combined with better access to family planning services, would radically reduce deaths and injuries, improving the lives of women and families in Ghana."

More than a third of all pregnancies in Ghana (37%) are unintended. This high level of unintended pregnancy is due to the fact that many women who do not want to become pregnant are not using an effective method of contraception. It is estimated that 35% of married women who wish to avoid pregnancy are not using a method of contraception—a much higher proportion than the average level of unmet contraceptive need in the African continent as a whole (22%).

In order to save women's lives and improve maternal health, the report recommends

• expanding access to family planning services and counseling;

• improving education for young people about reproductive health, including about the risks of unprotected intercourse and strategies for preventing unintended pregnancy; and

• increase public awareness about Ghana’s abortion law.

"Abortion in Ghana" can be found at http://www.guttmacher.org/pubs/IB-Abortion-in-Ghana.pdf