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Pregnancy termination, consequences, and influencing factors: A study on perceptions of women of childbearing age

Godson Chukwuemeka Ajuzie1,2, Osah Martins Onwuka3, Adaobi Linda Okerulu4

Author Affiliation

1Gastrointestinal Physiologist
2 Physiologist, Department of Community Health, Centenary College of Health Science and Technology, Emohua, Rivers State, Nigeria
3Human and Applied Physiologist
4Body fluid and Renal Physiologist, Department of Human Physiology, Faculty of Basic Medical Sciences, Gregory University, Uturu

Abstract

Background: Pregnancy termination is a controversial topic worldwide. Regardless of morality, unsafe termination of pregnancy contributes to a significant proportion of maternal mortality and morbidity in Nigeria. This study aimed to evaluate the perceptions of women aged 15–44 years about the factors that influence pregnancy termination and its consequences. Materials and Methods: This study used a descriptive survey design, focusing on women aged 15–44 years during a-3-month period from July to September, 2023. A total of 200 participants were selected through Simple Random Sampling Techniques. Participants completed a questionnaire comprising 16 items, rated on a 4-point scale from Strongly Agreed to Strongly Disagreed. Analysis of the questionnaire involved calculating the average weighted mean, with acceptance set at a mean value of 2.50 or higher and rejection for any mean value below 2.50. Results: The study revealed that most respondents recognized the consequences of pregnancy termination, with an average weighted mean of 3.4. Moreover, there was a correlation between discontinuing or avoiding childbearing and pregnancy termination (average weighted mean 3.4). Being a single mother also contributed (average weighted mean 3.6), and the level of education attained was associated with pregnancy termination (average weighted mean 3.2) among women of childbearing age. Conclusion: Respondents acknowledged that pregnancy termination has consequences and influencing factors, which underscore the importance of awareness and education, indicating potential areas for targeted interventions to address perceptions and factors influencing pregnancy termination in this demographic.

DOI: 10.63475/yjm.v3i1.4471

Keywords: Influencing factors, Perceptions, Pregnancy termination, Pregnancy

Pages: 43-47

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Download: 5

DOI URL: https://doi.org/10.63475/yjm.v3i1.4471

Publish Date: 11-05-2024

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INTRODUCTION

Pregnancy is a physiological process that begins with fertilization, where a sperm cell fertilizes an egg cell (ovum), forming a zygote. This zygote then undergoes multiple divisions, forming a blastocyst that eventually implants into the lining of the uterus. A woman carries and nurtures a developing fetus within her uterus, typically for about 40 weeks, divided into three trimesters [1, 2]. Prenatal care is essential during pregnancy, involving regular check-ups with healthcare providers, proper nutrition (avoidance of abortive herbs), and lifestyle adjustments. Monitoring the health of both the mother and the developing fetus helps identify and address potential issues early [2, 3].

Pregnancy termination is the deliberate ending of a pregnancy and it can be achieved through various methods; medical abortion (use of abortion pills in early weeks of pregnancy), vacuum or suction aspiration, Dilation and Curettage (D&C), Dilation and Evacuation (D&E) [4]. The choice to terminate is highly personal, influenced by factors such as the woman's health, fetal health, socioeconomic conditions, and personal beliefs [5]. In Nigeria, moral considerations regarding pregnancy termination are often influenced by cultural, religious, and legal factors [6]. Many Nigerians, especially those who are Muslim or Christian, view abortion as morally wrong due to religious teachings that emphasize the sanctity of life from conception [7]. Nigerian culture often places a strong emphasis on family and the importance of children. Therefore, pregnancy termination may be seen as conflicting with cultural values that promote childbirth and family unity [8]. Nigeria has restrictive laws regarding abortion, except when the life of the woman is in danger. This legal framework shapes moral perspectives on pregnancy termination and can lead to stigma and secrecy surrounding abortion [9]. The process of deciding on pregnancy termination necessitates careful consideration and consultation with healthcare professionals or a reproductive health clinic; in order to thoroughly assess available options, comprehend associated risks as well as benefits, and receive appropriate medical guidance [10]. There is global variability in the legality and accessibility of pregnancy termination services, emphasizing the need to ensure access to safe and legal procedures [11]. Given the dynamic nature of laws and regulations concerning pregnancy termination, obtaining location-specific information becomes crucial for informed decision-making [12]. Furthermore, the decision to terminate a pregnancy can evoke significant emotional challenges, underscoring the importance of a robust support system comprising healthcare providers, counselors, and a network of friends and family [13].

Unwanted or unplanned pregnancy among other factors highly influence the decision to terminate pregnancy as it poses a major economical, psychological, social, and/or religious challenge in women of reproductive age, especially in developing countries as it was estimated that, of the 210 million pregnancies that occur annually worldwide, about 80 million (38%) are unplanned and 46 million (22%) end in abortion [14, 15]. Examining the factors that influence pregnancy termination and perception of its consequences can serve as the foundation for a sensitization program aimed at reducing its prevalence among women of childbearing age. Therefore, this study aimed to assess the perceptions of women aged 15-44 years on the factors that influence pregnancy termination and its consequences in the context of local epidemiological settings in Nigeria.

MATERIALS AND METHODS

Design, area and population of study

This study with a descriptive survey design, carried out over a period of 3 months from July to September 2023, and focused on women of reproductive age (15 to 44 years) [16] in Ogba Local Government Area /Egbema/Ndoni of Rivers State. Ogba-Egbema-Ndoni is a local government area of Rivers State, Nigeria, located in Rivers West Senatorial District. Its capital is Omoku, and it was formerly known as Old Ahoada LGA. According to the 2006 Census, it has a population of about 258,700 people. The area is surrounded by Imo, Delta, Bayelsa, Abia, and Anambra states, as well as Ahoada West, Ahoada East, and Ubimini in Emohua Local Government Areas in Rivers State. The local population consists of three tribes: Ogba (dominant with 12 legislative wards), Egbema, and Ndoni (with 2 and 3 legislative wards, respectively). Ogba–Egbema–Ndoni is known for being an upland area and is a significant hub for upstream oil and gas exploration and exploitation activities since the early 1960s. The region hosts multiple mining and producing fields operated by companies such as AGIP, Total, and Shell/NPDC, with numerous other reserves. The area is represented in the Nigerian House of Representatives as part of the Ogba/Egbema/Ndoni/Ahoada West constituency. The Executive Chairman of ONELGA is Hon. Vincent Job. Traditional institutions include the Oba of Ogbaland, the Nze-Obi of Egbema Kingdom, the Awor of Ndoni, and recently, the Eze Egi of Egi Kingdom in Ogbaland, who was adopted and elevated to First-Class Status. The local geography makes it convenient to travel to the famous Onitsha World Market through the River Niger. Ogba–Egbema–Ndoni is endowed with vast arable and fertile land suitable for agricultural and industrial purposes [17].

Sample size and sampling technique

Sample Size was calculated as described by Ajuzie et al., [18]. A total of 200 participants, representing crucial areas in Ogba/Egbema/Ndoni Local Government Area, Rivers State, were selected through Simple Random Sampling Techniques. The sample comprised 20 Women of Childbearing Age each, chosen evenly from 10 communities within the LGA: Omoku, Obrikom, Okwuzi-Egbema, Mgbede-Egbema, Ndoni, Akabuka, Ogbogu, Kreigani, Aligwu, and Ikiri.

Instrument for data collection; validity and reliability

The study utilized a questionnaire named TOPAIDFAWOCBA to collect data on the termination of pregnancy and its determining factors among women of childbearing age in the Ogba/Egbema/Ndoni Local Government. The instrument consisted of 16 items, each rated on a 4-point modern scale ranging from Strongly Agreed (SA) to Strongly Disagreed (SD).

The researcher constructed and validated the research instrument. Prior to its administration, the instrument was presented to the project supervisor and two measurement and evaluation lecturers for corrections and suggestions. Their feedback was utilized to make necessary adjustments before the instrument was administered.

To assess the reliability of the instrument, a test-retest method was employed to measure the consistency of the items. The instrument was administered twice over a two-week period. The Average Weighted Mean Method was utilized for administration assessment. The correlation between the results of the first and second tests indicated no significant difference, suggesting that the instrument is reliable for use in the study.

Ethics, data collection and analysis

This study is part of a dissertation approved by Community Health Department, Centenary College of Health Science and Technology, Emohua, Rivers State, Nigeria. The study adhered to ethical considerations, obtaining informed consent from volunteered participants, and maintaining confidentiality throughout the process.

The researcher personally administered the research instrument to the respondents by hand, and retrieval was also done on the same day to prevent misplacement. The analysis of the research questionnaire was conducted using the average weighted mean. The criterion was set such that any mean value equal to or above 2.50 would be accepted, while any mean value below 2.50 would be rejected.

Decision rule:

            The nominal values were assigned to the rating scales as follows:

            Strongly Agreed (SA)                         =            4

            Agreed (A)                                          =            3

            Disagreed (D)                                     =            2

            Strongly Disagreed (SD)                    =            1

                                                  Thus: 1 + 2 + 3 + 4             = 10

                                                            = 10/4

                                                            = 2.5

Therefore, when X≥2.5, the statement or item was considered acceptable, but when the mean of the item X<2.5, the statement or item was rejected.

RESULTS

Consequences of pregnancy termination among women of child bearing age

The results presented (Table 1) revealed an average weighted mean of 3.4, indicating that the majority of respondents accepted the idea that pregnancy termination has consequences among women of childbearing age.

Table 1: Responses on consequences of pregnancy termination among women of child‑bearing age

Influencing factors of pregnancy termination among women of childbearing age

  1. Halting childbearing

The results (Table 2) illustrates that the majority of respondents acknowledged that discontinuing or avoiding childbearing is associated with pregnancy termination among women of childbearing age, with an average weighted mean of 3.4.

Table 2: Perceptions regarding the impact of halting childbearing on pregnancy termination among women of child‑bearing age

  1. Being a single mother

Results displays an average weighted mean of 3.6, suggesting that the majority of respondents accepted the notion that being a single mother contributes to the termination of pregnancy among women of childbearing age (Table 3).

Table 3: Perceptions regarding the impact of being a single mother on pregnancy termination among women of child‑bearing age

  1. Level of Education

This study result displays an average weighted mean of 3.2, indicating that the majority of respondents accepted the idea that the level of education attained contributes to the termination of pregnancy among women of childbearing age (Table 4).

Table 4: Perceptions regarding the impact of attained level of education on pregnancy termination among women of childbearing age

DISCUSSION

This study examined the perceptions of women of childbearing age regarding the consequences and influencing factors of pregnancy termination. The findings revealed that the majority of respondents acknowledged the potential consequences, including side effects on a woman's womb, the risk of death, malfunctioning of reproductive organs, and the possibility of internal and external bleeding. This report aligns with existing studies indicating that a significant number of women of childbearing age are aware of the associated risks of pregnancy termination, including issues related to the womb, organ malfunction, and internal/external bleeding [19].

Additionally, the respondents embraced the idea that influencing factors of pregnancy termination include discontinuing or avoiding childbearing, being a single mother, and the level of education which aligns to previous studies [20-23]. The findings indicated that some women of childbearing age view pregnancy termination as a means to stop childbearing, especially when other preventive measures fail. Termination of pregnancy is considered an easy option for teenage girls due to their underage status. Moreover, women of childbearing age express a preference for pregnancy termination over other methods. The influence of being a single mother is suggested by the tendency of single mothers to terminate pregnancies to prevent bearing more children out of wedlock, avoid further conception, cope with past frustrations, and address financial distress. Furthermore, the level of education attained emerged as a significant factor leading to pregnancy termination among women of childbearing age. This influence is observed within secondary school settings, where women of childbearing age may propose termination when they have not attained the desired level of education.

Study limitation

The scope of the study is limited to the perception of women of childbearing age about the consequences and factors that influence pregnancy termination, such as avoiding pregnancy, being a single mother, and level of education, however, this study did not evaluate participants' attitudes and other influencing factors such as unemployment, health programs, and others towards pregnancy termination to determine the extent of the problem in the area of study.

CONCLUSION

The study found that women of childbearing age accepted that pregnancy termination has consequences and that avoiding childbearing can lead to it. They also perceived being a single mother and education level as contributing to pregnancy termination. Based on the findings of the study, women of childbearing age should be mindful of the consequences associated with pregnancy termination and explore effective solutions to address and mitigate these consequences. Family planning, particularly in terms of discontinuing or avoiding childbearing, should be emphasized to prevent the need for pregnancy termination among women of childbearing age. Being a single mother should not be considered a sufficient reason for pregnancy termination. Instead, women in such situations should prioritize precautionary and preventive measures to avoid unintended pregnancies. The level of education attained by women of childbearing age should not necessarily be a determinant for pregnancy termination. Education should be promoted as a tool for informed decision-making rather than a factor leading to termination.

AUTHORS’ CONTRIBUTIONS

All authors made substantial contributions to the reported work, participating in various aspects such as conception, study design, implementation, data collection, analysis, and interpretation, as well as contributing to drafting, revising, and critically reviewing the article, and ultimately approving the final version for publication.

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