ABSTRACT
BACKGROUND: The prevalence and risk factors for unsafe abortions and their complications are not well defined. METHODS: A cross-sectional study of patient-reported reproductive history was conducted in three hospitals in southwest Nigeria from 1998 to 1999. Data on pregnancy outcomes and sociodemographic characteristics were collected for 1836 women ages 15-49 seeking family planning and antenatal services. Independent predictors for complications from induced abortion of first pregnancies were analyzed using logistic regression models. RESULTS: Four hundred twenty-four women (29.7%) terminated their first pregnancy. As many as 43.1% of women unmarried at first pregnancy had an abortion, and being unmarried at pregnancy was the strongest predictor of abortion in the adjusted model. Almost 30% experienced complications at the time of abortion (heavy bleeding, high fever, and other), and 22.9% reported complications subsequent to and within 6 weeks of abortion. Heavy bleeding and 6-week complications were significantly associated with age at pregnancy, circumcision, and religion, and 87.6% of women with 6-week complications reported complications for 1 day. Type of provider was the sole significant predictor of fever, and doctor provider reduced the risk of fever. Induced abortion and related complications were common despite the widespread provision by doctors. CONCLUSIONS: Policies and programs should address improving abortion practices and postabortion care, increasing contraceptive use, and reducing the practice of female circumcision.
Subject(s)
Abortion, Induced/adverse effects , Maternal Health Services/standards , Pregnancy, Unwanted , Women's Health , Abortion, Induced/statistics & numerical data , Adolescent , Adult , Counseling/statistics & numerical data , Cross-Sectional Studies , Female , Fever/etiology , Humans , Middle Aged , Mothers/education , Mothers/statistics & numerical data , Nigeria/epidemiology , Pregnancy , Risk Factors , Sepsis/etiology , Surveys and Questionnaires , Uterine Hemorrhage/etiologyABSTRACT
The AIDS epidemic in Nigeria is generalized, with infection primarily occurring through heterosexual transmission. It is important to understand patterns of sexual behavior to assess their impact on the epidemic and to design appropriate intervention strategies. This study examined risk factors for extramarital sex among Nigerian men, with a particular focus on polygyny and peri- and postpartum abstinence. Data from the 2003 Nigeria Demographic and Health Survey were analyzed for 1153 men and their wives. Eleven percent of men reported extramarital sex in the previous year. Logistic regression models showed that men with 3 or more wives were at the greatest risk for extramarital sex, followed by monogamous men, when compared with men with 2 wives. Other significant predictors included region, religion, wealth, age at sexual debut, and self-perceived risk of HIV infection. Peri- and postpartum abstinence was not significant. Based on these findings, HIV prevention programs should include men with 3 or more wives and those living in the southwest region, in addition to activities targeting men of all ages. Given the heterogeneity within Nigeria, further in-depth studies should be undertaken to explore the relation between number of wives, peri- and postpartum abstinence, and extramarital sex within specific communities.
