More women seek safe abortion

More women in Ghana are now opting for safe abortion services at regular health facilities as against the previous practice of taking concoctions and using crude methods to get rid of unwanted pregnancies.

Although the Ghana Health Service (GHS) has described this as positive based on the safer process at regular facilities and practitioners, the service prefers that the public opted for family planning methods and use them appropriately so that those who did not desire to be pregnant would resort to such preventive methods and avoid abortions, whether safe or unsafe.

“That would be what we can jubilate about because all family planning methods are effective in preventing unwanted pregnancy,” the Deputy Director of the Reproductive and Child Health Department of the GHS, Dr Chris Opoku Fofie, explained.

In an interview with the Daily Graphic, he said out of the 48,318 abortions recorded in the country in 2024, 15,246 of them were elective or safe abortions, which refers to patients seeking the service of health facilities to get the abortion done, going through all the processes, including counselling.

The figure is against the 9,177 cases recorded for self-induced abortion, which refers to unsafe methods where the individual starts the process by themselves, for instance, taking concoctions or using other crude methods.

For spontaneous abortion, technically referred to as miscarriages, Dr Fofie said 23,895 cases were recorded for the same period.

The 2024 figures were no different from those recorded for the four previous years.

In 2023, he said, whereas 15,767 elective abortion cases were recorded, the figures were 9,500 and 24,141, respectively, for self-induced abortion and spontaneous abortion.

Similarly, he said for 2022, 16,967 cases were recorded for elective abortion; 9,845 for self-induced abortion, while it was 26,258 for spontaneous abortion, totalling 53,070 cases.  

For 2021, 14,486 cases were recorded for elective abortion; 11,668 for self-induced abortion and 29,285 for spontaneous abortion, while elective abortion cases for 2020 were 11,983; 15,099 for self-induced abortion and 25,866 for spontaneous abortion.

Regions

Dr Fofie said regional figures were dominated by Ashanti and Greater Accra, the most populous regions, because they had more women in their reproductive years, revealing further that the cases were recorded more in women between 20 to 25 years for both elective and self-induced cases.

Abortion care programme

Providing reasons for the interest in elective abortion, Dr Fofie attributed it to a Comprehensive Abortion Care Programme introduced by the division three years ago to, among others, increase access to family planning services, create awareness among the public about the dangers of abortion and make family planning methods available so that women did not have to embark on unsafe abortion but to rather receive safe options.

Dr Chris Opoku Fofie, Deputy Director, Reproductive and Child Health Department, GHS

He said one major strategy to reduce abortion under the policy was the provision of places across the country where women could have access to very safe and effective modern family planning methods.

Throwing light on why some prefer abortion rather than enrolling on family planning methods, Dr Fofie said from experience gathered from the field, some married people might have opted to go for the abortion at a particular time because they had financial issues or they wanted to travel and immediately after they plan to have a child.  

For this reason, he added, healthcare workers could not insist that because they had had an abortion, they should receive family planning.

Self-induced abortion

Dr Fofie said one major effect of unsafe abortion is excessive bleeding, adding that some could die from that.

He said a long-term consequence of self-induced abortion was the infertility that came with it. “Imagine a situation where the abortion is not done successfully and there are products in the womb for three or four weeks.

All that gets infected and after that, even if you are treated, it could affect the inner part of the womb.

The tubes could be blocked, and future conception becomes difficult or impossible. So that's the infertility that we get from that,” he explained.

Dr Fofie said if the abortion was done by an unskilled person, there could be a perforation or scraping of the womb, which could come with challenges.

There are also the likely psychological problems where one would think that they would be unable to give birth because of the abortion they caused.

Challenges

He said people not seeking safer abortion services at health facilities could also suffer stigma, explaining that people considered abortion to be taboo, so they feared to openly talk about it, let alone have one.

To deal with the stigma, he called for an open talk on abortion and where it could be provided safely, adding that as a service, they were working with religious groups and all concerned to ensure that whatever services they provided were sensitive enough to protect the culture of the people.

Weija

Meanwhile, when the Daily Graphic visited the Weija Government Municipal Hospital, a health facility that offers safe abortion services, a Deputy Director in charge of Nursing Services, Carolina Fati Asigri, mentioned in an interview that the greatest challenge to health providers was the fact that those who access abortion services were often reluctant to adopt a family planning method after the pregnancy had been terminated.

She said those who accepted to take a family planning method were not up to 20 per cent of the cases seen, with the number featuring some adolescents below 15 years.

“Society is stigmatising family planning methods, and women are not open to accepting it even when they come for a termination. Young ones grow up with that fear that if they take a family planning method, they might not be able to deliver again,” she said.

Ms Asigri advised young girls that sex was something they might not be able to control and that they rather needed to know more about the prevention of unwanted pregnancies and safe sex, adding that although abstinence was the best tool, where anyone could not abstain, they should take up a family planning method.

She said that in a week, they attended to approximately four to eight safe abortion cases and that more of the women who sought such services were between 19 to 24 years, although they sometimes also attended to cases of those below 15 years.

She disclosed that because more women were now seeking safe abortion at the facility, for a long time they had not had a case of a woman having a ruptured womb or dying due to abortion complications, adding that the common complication they saw was bleeding, which, she explained, was sometimes so profuse that they required blood transfusion. 

Patients

In interviews conducted with patients who had patronised both safe and unsafe abortion services at the hospital, they said they had not started a family planning method ever since they lost the pregnancy. Despite several questions, they were unable to give reasons as to why they had not enrolled on any family planning method.