Tisha M. Mitsunaga, MS, Department of Population and International Health, Harvard School of Public Health, 161 Cypress Street, Brookline, MA 02445, 617-645-0428, tmitsuna@hsph.harvard.edu, Ulla M. Larsen, PhD, Department of Population and International Health, Harvard University, School of Public Health, 667 Huntington Avenue, Building 1, Room 1109, Boston, MA 02115, and Friday E. Okonofua, MD, Deparment of Obstetrics and Gynaecology, University of Benin and Women’s Health and Action Research Centre, P.O. Box 10231, Benin City, Nigeria.

Objectives: To determine the risk factors associated with self-reported complications from induced abortions in Southwest Nigeria. Methods: A cross-sectional survey was administered to women seeking family planning and antenatal services at three hospitals in 1998-1999. Data were analyzed for 1,851 women aged 15-49. Statistical analyses were performed using multivariate logistic regression models to determine the predictors for abortion-related complications. Results: There were 424 women who reported having an induced abortion during their first pregnancy. Of these, 29% (n=122) reported complications within one day (heavy bleeding, fever and other) and 23% (n=97) within 6 weeks of the abortion. Independent risk factors for heavy bleeding included: circumcision (OR = 1.9; 95% CI 1.1-3.4), age 30-39 and 40-49 at time of survey, age 15-19 at pregnancy, and being Protestant or Catholic. The independent risk factor for fever was non-doctor provider (OR = 7.9; 95% CI 2.1-30.4). Independent risk factors for 6 week complications were: circumcision (OR = 2.5; 95% CI 1.4-4.4), age 40-49 at time of survey, age 15-19 at pregnancy, employment in formal sector, and primary and below education (OR = 3.2; 95% CI 1.3-8.3). Conclusions: Although abortion is illegal in Nigeria, it is highly prevalent. While it appears that abortion practices are becoming safer, complications are common. Further, these results emphasize the need to make abortions legal in order to advocate for safe practices, and reduce the number of abortions (and thus the complications) through effective family planning education and services.

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