Estimating the incidence of abortion-related complications using the prospective morbidity survey method in Southern Ethiopia

Abstract

Despite legal reforms, unsafe abortion remains a significant public health problem in Ethiopia, straining healthcare systems and impacting women's well-being. Recent data on the magnitude of this problem are scarce. Therefore, this study aimed to assess the incidence and factors associated with abortion-related complications in public hospitals in Southern Ethiopia. Using the prospective morbidity survey (PMS) methodology, data were obtained from 322 women who presented in 10 public hospitals over a two months period (December 2023 - February 2024). The results show that the projected annual estimate of abortion related complications was 1,986 (95% CI: 1741, 2142), translating to a complications ratio of 153 per 1,000 live births. Out of the 322 women, 67 (20.8%) were classified as having near-miss morbidity (MNM), 167 (50.8%) had potentially life threatening complications (PLTC), while 35 (10.9%) and 57 (17.7%) women had moderate and mild morbidities respectively. Ordinal logistic regression identified younger age, rural residence, unemployment, later trimester abortion, lack of contraception use, unintended pregnancy, and expulsion of some products of conception as factors associated with increased severity of complications. These findings highlight the high burden of severe abortion complications and underscore the critical need for improved access to comprehensive family planning, safe abortion services, and timely, quality post-abortion care, particularly for vulnerable populations in Southern Ethiopia.