Research Articles (Statistics & Population Studies)

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Browsing by Subject "Abortion"

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    Determinants of women’s preferred and actual abortion provision locations in Nigeri
    (Springer, 2021) Byrne, Meagan E; Omoluabi, Elizabeth; OlaOlorun, Funmilola
    Background: Unsafe abortion remains a leading cause of maternal mortality globally. Many factors can infuence women’s decisions around where to seek abortion care; however, little research has been done on abortion care decisions at a population-level in low-resource settings, particularly where abortion is legally restricted. Methods: This analysis uses data from a 2019–2020 follow-up survey of 1144 women in six Nigerian states who reported an abortion experience in a 2018 cross-sectional survey. We describe women’s preferred and actual primary abortion care provider/location by distinguishing clinical, pharmacy/chemist, or other non-clinical providers or locations. We also examine factors that infuence women’s decisions about where to terminate their pregnancy and identify factors hindering women’s ability to operationalize their preferences. We then examine the characteristics of women who were not able to use their preferred provider/location. Results: Non-clinical providers (55.0%) were more often used than clinical providers (45.0%); however, clinical providers were preferred by most women (55.6%). The largest discrepancies in actual versus preferred abortion provider/ location were private hospitals (7.6% actual versus 37.2% preferred), government hospitals (4.3% versus 22.6%), chemists (26.5% versus 5.9%) and pharmacies (14.9% versus 6.6%). “Privacy/confdentiality” was the most common main reason driving women’s abortion provider/location choice (20.7%), followed by “convenience” (16.9%) and “recommended” by someone (12.3%), most often a friend (60.8%), although top reasons difered by type of provider/ location. Cost and distance were the two most common reasons that women did not use their preferred provider/ location (46.1% and 21.9%, respectively). There were no statistically signifcant diferences in the sociodemographic characteristics between women who were able to use their preferred provider/location and those who were not able to implement their preferred choice, with the exception of state of residence. Conclusions: These fndings provide insights on barriers to abortion care in Nigeria, suggesting discretion is key to many women’s choice of abortion location, while cost and distance prevent many from seeking their preferred care provider/location. Results also highlight the diversity of women’s abortion care preferences in a legally restrictive environment.
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    Menstrual regulation: Examining the incidence, methods, and sources of care of this understudied health practice in three settings using cross-sectional population-based surveys
    (BMC, 2023) Bell, Suzanne O.; Shankar, Mridula; Omoluabi, Elizabeth
    Menstrual regulation is a practice that may exist within the ambiguity surrounding one’s pregnancy status and has been the subject of limited research. The aim of this study is to measure the annual rate of menstrual regulation in Nigeria, Cote d’Ivoire, and Rajasthan, India, overall and by background characteristics and to describe the methods and sources women use to bring back their period. Data come from population-based surveys of women aged 15–49 in each setting. In addition to questions on women’s background characteristics, reproductive history, and contraceptive experiences, interviewers asked women whether they had ever done something to bring back their period at a time when they were worried they were pregnant, and if so, when it occurred and what methods and source they used. A total of 11,106 reproductiveaged women completed the survey in Nigeria, 2,738 in Cote d’Ivoire, and 5,832 in Rajasthan. We calculated one-year incidence of menstrual regulation overall and by women’s background characteristics separately for each context using adjusted Wald tests to assess signifcant. We then examined the distribution of menstrual regulation methods and sources using univariate analyses.
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    A mixed-methods study exploring women’s perceptions of terminology surrounding fertility and menstrual regulation in Côte d’Ivoire and Nigeria
    (BMC, 2021) Sheehy, Grace; Omoluabi, Elizabeth; OlaOlorun, Funmilola M.
    Women use various terms when discussing the management of their fertility and menstrual irregularities and may interpret the experience of ending a possible pregnancy in nuanced ways, especially when their pregnancy status is ambiguous. Our study aims to understand the terminology used to refer to abortion-like experiences (specifcally menstrual regulation and pregnancy removal), and the specifc scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d’Ivoire.Our analysis draws upon surveys with women in Nigeria (n=1114) and Cote d’Ivoire (n=352). We also draw upon qualitative in-depth interviews with a subset of survey respondents in Anambra and Kaduna States in Nigeria, and Abidjan, Cote d’Ivoire (n=30 in both countries). We examine survey and interview questions that explored women’s knowledge of terminology pertaining to ending a pregnancy or bringing back a late period. Survey data were analyzed descriptively and weighted, and interview data were analyzed using inductive thematic analysis.