Source: The Conversation. By D. Yaw Atiglo, Charlotte Abra Esime Ofori, University of Ghana.
Ghana’s abortion law is relatively liberal. Abortion is legally permitted in the first trimester when a pregnancy endangers the mother’s life or physical or mental health, or when it is due to rape or incest. Thus, medication abortion has become more widely available.
Medication abortion involves the use of mifepristone and misoprostol pills which stop pregnancy and enable the uterus to expel it naturally. When used correctly and with proper guidance it is an acceptable, effective and safe method.
Despite the availability of this safe method, however, it’s not always used in Ghana, especially by young women. The 2017 Ghana Maternal Health Survey reported that over a quarter of induced abortions nationally used non-medical methods. And only two out of every five induced abortions involved health personnel such as doctors, nurses and midwives.
Studies also indicate that some medical methods occur outside the health system and are not supervised by licensed health professionals. Stigma, misconceptions, privacy concerns, inequitable access to services, and cost continue to drive young women to methods that are not fully safe.
Unsafe abortions cause preventable illnesses and death, and are a serious public health issue.
The World Health Organisation classifies abortion safety into three categories: safe, less safe, and least safe.
Abortion is safe if it is a WHO-recommended method appropriate for pregancy duration, and provided by trained health professionals in an appropriate health facility. Less safe abortions are cases where a recommended method, such as medication abortion, is used without proper medical supervision or outside appropriate health facilities. Least safe abortions involve non-recommended methods often administered by untrained individuals and not conducted in an approved health facility.
It is not safe to use abortion pills without professional supervision, insert foreign objects, ingest herbal concoctions, alcoholic and sugar liquids or assorted tablets, or attempt heavy massage or rigorous physical activity.
Our team of demographers and social scientists investigated the prevalence, drivers and spatial distribution of abortion methods in Ghana.
We conducted research, using data from the 2017 Ghana Maternal Health Survey, to test the assumption that the rise of medication abortion automatically guarantees safety. Our study analysed data from 1,561 women aged 15 to 34 who had an induced abortion in the five years preceding the 2017 survey.
The results were stark: only about 11.5% of abortions were deemed safe; 40.7% were less safe; and 48% were least safe. In other words, most abortions among young women in Ghana fell into the less safe and least safe categories, even though safe methods are available.
The reason is that many young women obtain abortion pills from community pharmacies or chemist shops without prescriptions, medical assessment, or guidance on dosage. Others use non-recommended and dangerous methods. These gaps matter. The WHO and Ghana Health Service protocols require specific dosages based on duration of pregnancy to prevent complications. Without this oversight, even what is supposed to be a safe method becomes a risky method.
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