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Decision making on unsafe abortions in Sri Lanka: a case-control study
Carukshi Arambepola1, Lalini C Rajapaksa
1Department of Community Medicine, University of Colombo, Kynsey Road, Colombo 8, Sri Lanka. carukshi@yahoo.com.
Reproductive Health
|December 19, 2014
Summary
Women facing unintended pregnancies in Sri Lanka often opt for unsafe abortions due to unreliable information, poor partner support, and economic instability. Seeking advice from non-medical sources significantly increases the risk of unsafe procedures.
Area of Science:
- Public Health
- Reproductive Health
- Sociology
Background:
- Unintended pregnancies present complex decision-making scenarios for women, involving factors favoring and opposing abortion.
- Societal and personal circumstances significantly influence a woman's choice between unsafe abortion and continuing a pregnancy.
Purpose of the Study:
- To investigate the factors influencing women's decisions to undergo unsafe abortions versus continuing unintended pregnancies in Sri Lanka.
- To compare the characteristics and decision-making processes of women undergoing unsafe abortions with those carrying unintended pregnancies to term.
Main Methods:
- An unmatched case-control study involving 171 women post-unsafe abortion (cases) and 600 women delivering unintended pregnancies (controls).
- Data collection utilized interviewer-administered questionnaires and in-depth interviews to explore women's characteristics and decision-making rationales.
- Statistical analysis employed odds ratios (OR) and 95% confidence intervals (CI) to assess the risk associated with decision-making factors.
Main Results:
- Women undergoing unsafe abortions were more likely to be less educated, employed, unmarried, and nulliparous.
- Reliance on non-medical sources for information (spouse, friends, family) and prior experience with induced abortions increased the risk of unsafe abortion.
- Economic instability and lack of partner support were primary drivers for choosing unsafe abortion, while ethical and religious beliefs influenced decisions to continue pregnancies.
Conclusions:
- The risk of unsafe abortion is significantly linked to reliance on unreliable information sources, leading to misperceptions about safety.
- Limited access to safe and affordable abortion services, coupled with economic vulnerability, contributes to higher rates of unsafe procedures.
- Interventions should focus on improving access to accurate information, enhancing partner support, and addressing socioeconomic determinants to reduce unsafe abortion prevalence.
