Prevalence of Induced Abortion among Female Students in Selected Tertiary Learning Institutions in Gaborone City, Botswana

Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ2 = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.

Clinical Observation of Misoprostol before and after Painless Induced Abortion

Background: Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. Objective: To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. Methods: 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion;in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation;in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. Results: Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The duration of bleeding in group B was less than that in group A (P < 0.05). The percentage of cervical relaxation in group A and B was higher than that in group C (P < 0.05). The rate of incomplete abortion in group B < group A < group C (P < 0.05), and there was no residual uterine cavity in group B. Conclusion: The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).

Comparison of Depression and Anxiety between Unmarried Female Youth in Two Groups of Induced Abortion and None-Induced Abortion in Yibin City of China

Objectives To explore the risk factors influencing the mental status of unmarried female youth. Methods ,4 cross-sectional survey and a qualitative interview were adopted. 1200 unmarried female volunteers （600 with 1,4） who aged 15-29 years in Yibin city were investigated, and 8 focus group discussions （FGDs） and 8 in-depth interviews were conducted. Except the investigation of subject＇s personal information, econ-socio status, sexual behavior, contraception and reproductive health problems they face, two selfreporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results 1） Depression and anxiety among unmarried female youth investigated in current study are relatively common. Proportions of the females with depression and anxiety to the total sample are 27.4% and 33.4%, respectively; 2） Depression and anxiety of the females with 1,4 are more serious than that of the female without 1,4. Proportions of unmarried females with IA have depression and anxiety to the total unmarried females with 1,4 are 3.45 times and 2.61 times that of unmarried females without 1,4 have depression and anxiety to the total unmarried females without 1,4, respectively; 3） IA is one of the key risk factors influencing depression and anxiety of unmarried female youth. Other risk factors are lack on basic knowledge about sex/ STD/HIV/AIDS, reproductive tract infections, relatively lower income, age at sex debut is relatively younger, etc. In addition, multiple sex partners and repeat pregnancies were risk factors influencing anxiety of unmarried female youth. Conclusion Depession and anxiety was more popular in unmarried females with IA Intervention for improving mental health of unmarried females should be developred Key words：

Improving Sexual and Contraceptive Behaviours of Unmarried Female Youth with First Trimester Induced Abortion in Sichuan,China

Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion（IA） youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours of unmarried IA youth. Methods Intervention epidemiological surveys （baseline and evaluation） plus qualitative interview were used. During July 2002 and July 2003, 2 484 unmarried female volunteers who aged 15-29 years and come to clinics seeking abortion were recruited by cluster random sampling from the four selected regions of Sichuan, 48 volunteers were interviewed for 8 focusgroup discussions （FGDs） and 16 in-depth interviews equally for each survey. Information, education anol communication（IEC） materials, education sessions, trainings and counseling were given to subjects and service providers during the project implementation. Questionnaires for surveys and guidelines for qualitative interviews were used. Results Comparison of the after with the before intervention. 1） the proportion of respondents having knowledge about sexuality was increased by 13%. Among them, the proportion of respondents got part and most of the knowledge was increased by 43%. Maximum number of sex partners the respondents have decreased from 9 to 4. Respondents＇partnerships have gradually changed from more acquaintances/school mates/boyfriends to fianés mainly; 2） respondents＇ contraceptive use rate was increased by 20%. Among them, the condom use rate increased rapidly to 80%. Purposes of condom use were changed from only for contraception to for prevention of HIV/AIDS/STDs and pregnancy. And most of respondents stabilised their method use - condoms. Most of respondents suggested condoms was the method most suitable for unmarried IA youth, this proportion was increased by 44%; 3） proportion of respondents knowing more about consequences of induced abortion was increased by 24%; and 4） proportions of respondents having depression and anxiety symptoms were decreased by 66% and by 61%, respectively. Conclusion The intervention including IEC materials, education, training and counseling was effective in improving sexual and contraceptive behaviours of unmarried IA youth.

Characteristics of Induced Abortion in China in the 1990s

Objective To understand the characteristics of induced abortion in China in the 1990s, and to find out the influential factors. Methods The overall number of induced abortions, calculate cohort induced abortion frequency, explore the impact of a child＇s sex and the number of previous children on induced abortions were estimated by using the data from the ＂National Poptdation and Reproductive Health Survey＂ conducted by the National Family Planning Commission in November 1997. Results Induced abortions in China had their own characteristics, which were far different from other countries. The main difference was led by the fact that the country was driven by an implemented family planning program and nationwide population policies. The key cause of induced abortions was due to an inconsistentT with the requirements of the family planning policy. However, as a result of effective and prevalent contraception, the rates of induced abortions were not quite high in the 1990s, when compared with other countries. Even though, in the early 1990s, the government had reinforced the family planning program through administration and legislation, unlike during the early 1980s when the one-child policy was implemented, the induced abortion rate and the number of induce abortions did not increase as the fertility rate substantially decreased. Conclusion This finding implies that the fertility declines in the 1990s were not caused by the number of induced abortions. The transition of the fertility ideology of the people has played an important role in the fertility decline, as institutional reform and socioeconomic development are implemented.

Induced Abortion, Mortality, and the Conduct of Science

There is no credible scientific opposition to the fact that a genetically distinct human life begins at conception and that an induced abortion is a death. Yet, abortion is not reported as a cause of death in the U.S. vital statistics system. Mortality patterns have profound implications for public policy. As a cause of death, we found abortion to be highly consequential, with large racial and ethnic disparities. Abortion represented 16.4% of non-Hispanic White deaths, but 61.1% and 64.0% of non-Hispanic Black and Hispanic deaths respectively. For Years of Potential Life Lost (YPLL), the ubiquitous measure of premature death, abortion accumulated 63.1% of non-Hispanic White YPLL and 86.5% and 87.4% of non-Hispanic Black and Hispanic YPLL respectively. Further, as measured by the availability of valid data and resources allocated for research, there is evidence that the science community is not appropriately engaged on this crucial public health problem.

Effect of emotion management and nursing on patients with painless induced abortion after operation

BACKGROUND With an estimated 121 million abortions following unwanted pregnancies occurring worldwide each year,many countries are now committed to protecting women’s reproductive rights.AIM To analyze the impact of emotional management and care on anxiety and contraceptive knowledge mastery in painless induced abortion(IA)patients.METHODS This study was retrospective analysis of 84 patients with IA at our hospital.According to different nursing methods,the patients were divided into a control group and an observation group,with 42 cases in each group.Degree of pain,rate of postoperative uterine relaxation,surgical bleeding volume,and postoperative bleeding volume at 1 h between the two groups of patients;nursing satisfaction;and mastery of contraceptive knowledge were analyzed.RESULTS After nursing,Self-Assessment Scale,Depression Self-Assessment Scale,and Hamilton Anxiety Scale scores were 39.18±2.18,30.27±2.64,6.69±2.15,respectively,vs 45.63±2.66,38.61±2.17,13.45±2.12,respectively,with the observation group being lower than the control group(P<0.05).Comparing visual analog scales,the observation group was lower than the control group(4.55±0.22 vs 3.23±0.41;P<0.05).The relaxation rate of the cervix after nursing,surgical bleeding volume,and 1-h postoperative bleeding volumes were 25(59.5),31.72±2.23,and 22.41±1.23,respectively,vs 36(85.7),42.39±3.53,28.51±3.34,respec tively,for the observation group compared to the control group.The observation group had a better nursing situation(P<0.05),and higher nursing satisfaction and contraceptive knowledge mastery scores compared to the control group(P<0.05).CONCLUSION The application of emotional management in postoperative care of IA has an ideal effect.

Diverging destinies:changing trends of induced abortion in China

In the era of the second demographic transition,“diverging destinies”theory states that women with the most economic opportunities often obtain gains while women with the least economic opportunities suffer from losses.Using nationally represent-ative data from the 2017 China Fertility Survey,we attempted to examine if diverg-ing destinies theory can explain differences in the incidence of induced abortion among women with differing economic opportunities.We found that women with good economic opportunities(i.e.,well-educated and holding urban hukou)were more likely to have induced abortions between 1980 and 2010 and less likely to do so between 2015 and 2017.Moreover,younger cohorts were far more likely to have induced abortions at a younger age and before marriage.These findings provide sup-portive evidence for diverging destinies in induced abortion scenarios in China.We thus advocate that sexual and reproductive health policy making shows an overarch-ing concern for the interests of disadvantaged groups.

Lower uterine segment pregnancy with placenta increta complicating first trimester induced abortion: diagnosis and conservative management

r Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion in the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed “lower uterine segment pregnancy with placenta increta”. Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.

Induced Abortion and the Risk of Tubal Infertility

Objective To explore the association between induced abortion and tubal infertility in Chengdu, China.Methods A 1 ： 2 case-control study was designed. Infertile women with bilateral tubal occlusion in the case group compared with two control groups： infertile control group with bilateral tubal patency and pregnant control group with currently pregnancy. Data were collected using questionnaires through face-to-face interviews, covering the subjects＇ demographic details and histories of gynecology and obstetrics. Adjusted odds ratio was calculated as a measure of the association using stepwise multiple logistic regression analysis.Results Induced abortion was not found to be associated with tubal infertility in the analysis including either the infertile controls or the pregnant controls, but other risk factors were found, such as history of acute pelvic inflammatory disease （PID）, lower abdominal surgeries, dysmenorrhea and pregnancy.Conclusion It is contended that facing an increasing trend of infertile cases with tubal occlusion in China, it is emphasized that special attention should paid to the long term impact of reproductive tract infection, especially, asymptomatic ones, rather than induced abortion.

Uterine Artery Rupture After Induced Abortion and Extraction of an Intrauterine Device

An intrauterine device （IUD） is a safe, effective, simple, and reversible method tbr birth control, but some women with IUD may still become pregnant. Induced abortion is the main method for termination of pregnancy. If induced abortion is not well-managed in these patients, it may result in serious vaginal bleeding and uterine rupture. We report a case of uterine artery rupture after induced abortion combined with extraction of an IUD. This case highlights the necessity of a standard operation for complicated induced abortion, and the value of interventional therapy, such as uterine artery embolization （UAE）, for controlling serious vaginal bleedit3g.

Induced abortion among married women in China:a study based on the 1997-2017 China Fertility Surveys

This study uses four sets of data from China Fertility Surveys completed during the years 1997-2017 to analyze the trend of induced abortion,with a focus on the twenty-first century.Married women of reproductive age who had a history of pregnancy during the 5 years prior to participating in a survey were the research object.The study also examines the variation of abortion proportions among different subgroups during different time periods,including an examination of the number and gender of children,place of residence,and contraceptive use of women who had induced abortions.The results show that the occurrence of induced abortion has decreased gradually,and that the risk of induced abortion was higher for those who had given birth to fewer children.However,induced abortion among women with two children has increased in recent years.It is noteworthy that induced abortions among childless premarital women have continued to increase in recent years,and that the sexual and reproductive health problems of adolescents remain of great concern.The occurrence of induced abortions after childbirth increased for those with one or two children,showing that the unmet need for contraception after childbirth should receive more attention.In addition,sex-selective abortion has been decreasing gradually,but still exists today.

Induced abortion among unmarried women in China

This study uses a literature review to probe the prevalence and trends of induced abortions among unmarried women since the 1980s.Premarital pregnancy has become more and more common,and this has pushed the premarital abortion rate still higher.With the premarital abortion rate remaining markedly high in China,the percentage of women who have experienced premarital abortions has risen stead-ily with the passage of time.Not only has the prevalence of premarital abortions increased in China on the whole,but there is evidence that some young women have had multiple abortions.Premarital abortion is more prevalent in urban areas and among migrants and less-educated women.The huge number of premarital abor-tions not only signifies a palpable,unmet need for contraceptives,but also repre-sents an immense number of unrealized births.In the years to come,it is imperative to strengthen research into premarital abortions,to optimize the approaches to data collection and analysis,and to improve reproductive health services for unmarried women.

Use of Emergency Contraception could Halve Induced Abortion Ratein Shanghai, China

Objective To investigate and estimate the proportion of the induced abortion that could have been prevented by using emergency contraception in Shanghai Method Structured interviews were conducted in 606 women (413 married and 193 unmarried) aged 18-49 years, who were attending three health care centers in Shang- hai for termination of first trimester pregnancy. Results A total of 98.2% of the pregnancies were unwanted, and 63.7% of the women recognized that they were at risk of pregnancy soon after the intercourse. It is estimated that 52.2% of the induced abortion could have been prevented if the women had used levonorgestrel-only emergency contraception. Only 28.5% of the respondents were aware of emergency contraception. The most important sources of information about emergency contraception identified by respondents were books/newspapers/periodicals (38.2%), and relatives/friends (30.6%). Family planning health education on emergency contraception was noted by 28.9% of married women but only by 5.8% of unmarried women. A portion of 85.5% of all respondents reported they would be willing to use emergency contraception when needed. Those more willing to use emergency con- traception included younger, better educated, and unmarried women experiencing their first pregnancy. Women preferred drugstores (60.1%) than hospitals (30.2%) for obtaining emergency contraception. Conclusion Women’s needs for emergency contraception were enormous. Promotion of emergency contraception by providing information and improving service could have a substantial impact on reducing the rate of induced abortion in Shanghai.

Regulative effect of Taohong Siwu decoction(桃红四物汤) on extracellular matrix of endometrium in drug-induced abortion

OBJECTIVE: To explore the effects of Taohong Siwu decoction(桃红四物汤, THSWD) on the extracellular matrix of endometrium in rats following drug-induced abortion.METHODS: Thirty-six pregnant female rats were administered mifepristone and misoprostol to induce abortion, and amounts of uterine bleeding were recorded. Pathological damage and collagen accumulation were detected by hematoxylin-eosin staining and Masson’s trichrome staining in uterus, respectively. Myeloperoxidase was evaluated by immunohistochemistry.The expression levels of fibronectin, laminin, matrix metalloproteinase 9(MMP-9), and tissue inhibitor of metalloproteinase 1(TIMP-1) were quantified using western blotting.RESULTS: THSWD could promote endometrial protection in rats following drug-induced abortion.The contents of cellulose and myeloperoxidase were significantly decreased in uterine tissue of THSWD-treated groups. Moreover, THSWD significantly decreased the expression levels of fibronectin, laminin, and TIMP-1. THSWD also significantly increased MMP-9 expression and the MMP-9/TIMP-1 ratio.CONCLUSION: THSWD plays a critical role in endometrial protection by reducing extracellular matrix deposition and uterine fibrosis. These effects may have been achieved by increasing MMP-9, reducing TIMP-1, and/or altering the ratio of MMP-9/TIMP-1.

Studies on Relationship between Serum Nitric Oxide and Plasma Cyclic Guanosine Monophosphate and Prolonged Bleeding after Medical Abortion as well as Prophylaxis and Treatment of Bleeding with Traditional

Objectives To study the relationship between serum nitric oxide (NO and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. Methods A total of 120 women having received medical abortions at random were recruited and divided into two groups: the one (Group A,n=60) taking 'Gong Fu Mixture(Uterus Recovering Mixture)' and the other (Group B,n=60) not taking it after abortion. On d 10, 20 and 30 after medical abortion, serum NO and plasma cGMP were tested before and after mifepristone administration and 10 d later by Gresis reaction method and radioimmunoassay respectively. Results NO concentration in serum and cGMP concentration in plasma decreased significantly after taking mifepristone given (P<0.05). Ten days later, the number of those with bleeding discontinuation in the group A was significantly greater than that in the group B (P<0.05). Serum NO level and plasma cGMP level in the group A decreased more significantly than those in the group B (P<0.05). Conclusion The slow decrease of serum NO and plasma cGMP is closely related to prolonged bleeding after medical abortion. “Gong Fu Mixture (uterus recovering mixture)” is effective in prevention and treatment of prolonged bleeding.

Clinical Observation of Disposal Uterine Cavity Observation and Suction Surgery System on Terminating Pregnancy in Very Early Pregnancy

Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients who requested termination of pregnancy due to early pregnancy from August 2022 to April 2023, and analyze the data. 40 patients who underwent ultrasound-guided induced abortion to terminate pregnancy were included in the control group, and 40 patients who underwent uterine cavity observation surgery to terminate pregnancy were included in the observation group. Compare the surgical time, number of times the straw enters the uterine cavity, incidence of complications, and menstrual recovery time between the two groups. Results: There was no statistically significant difference in the surgical time between the observation group and the control group, but the number of times negative pressure straws entered the uterine cavity and the incidence of surgical complications in the observation group were significantly lower than those in the control group (P Conclusion: Applying the uterine cavity observation and suction surgical system to terminate pregnancy in very early pregnancy has the advantages of minimal damage to the uterus and low incidence of surgical complications, greatly protecting the patient’s fertility.

Sexual Conduct before Marriage and Subsequent Marital Happiness in Shanghai

Objective To investigate the links between wives＇ marital happiness and premarital sex and related consequences in Shanghai during 1980s Methods About 8 000 newly married couples were followed up at the 3rd and 15th month after their marriage. Results About 12% of them reported premarital intercourse. This proportion was higher among less educated couples with blue-collar jobs. About 63% of the sexually active caused pregnant before marriage. Most pregnancies were legitimised by marriage but 1/4 ended in induced abortion. Over 3/4 （78%） of wives reported that they were happy with the marriage in general, while 72% of wives were happy with the sexual aspects of their marriage. Results showed a strong relationship between marital happiness and the occurrence of a premarital abortion. Less educated and latearring women were more likely to assess their marriage neutrally or negatively. Conclusion Unhappiness with marriage in general and with marital sexual life were significantly higher among women with premarital abortion, and among less educated and late-marrying women.

Effect of intervention on the contraceptive efficacy among married reproductive women

Objective: To determine the effect of intervention on contraceptive efficacy. Method: The study is composed of three phases: (1) A baseline survey was conducted from Aug. to Dec., 1991. (2) An intervention program, which included strengthening education and introducing new contraceptive methods, was implemented from Jan. to Feb., 1992. (3 ) From Feb. to March, 1994, the second survey was carried out. Results: Main results are very successful. The rate of induced abortion decreased after intervention. The rate of contraceptive discontinuation after intervention was lower than that before intervention. Conclusion: The intervention program was very effective.