Pregnancy options counselling in Ghana: a case study of women with unintended pregnancies in Kumasi metropolis, Ghana

Background

Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to the absence/inadequate pregnancy options counseling for clients to make informed decisions. This study examines options counseling for abortion seekers in health facilities in Ghana.

Methods

The analytical cross-sectional study design was done in selected specialized public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analyzed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square, and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study.

Results

Respondents had divergent reproductive and socio-demographic profiles. The majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counseling was observed to be significantly associated with parity (P = < 0.001), gestational age (P = < 0.001), previous induced abortions (P = < 0.001), perception of pregnancy at conception (P = < 0.001) and level of education (P = 0.002). The logistic regression analysis also shows that higher education has a statistically significant effect on being exposed to options counseling (P = < 0.001). The majority of respondents (95%) were not aware that giving a child up for adoption is an option for abortion in Ghana.

Conclusions

Pregnancy options counseling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly expose women to options counseling for informed decisions, the less educated are disadvantaged in this regard. Further research on the type and depth of counseling services provided to pregnant women in health facilities is required to inform health policy and program decisions.