Reasons Women Request for Termination of Pregnancy at a Rural Hospital in Zambia; A Cross Sectional Study at Mansa General Hospital, Mansa District, Zambia

Background: Globally, it is estimated that unsafe abortions contribute to 8% of maternal deaths. Sub-Saharan Africa has the highest regional estimate of abortion related mortality at 90 per 100, 000 live births. In Zambia the reasons for the termination of pregnancy is enshrined in the Termination of Pregnancy Act of 1972 which states that an abortion may legally take place if the continuation of the pregnancy involves a risk to the pregnant woman's life, physical or mental health; a risk to the physical or mental health of any existing children; or if there is a substantial risk that the child will be born with birth abnormalities. The Termination of Pregnancy Act further specifies that the pregnant woman's actual or reasonably foreseeable environment may be considered. In this study, we set out to assess the reasons women give when requesting for a termination of pregnancy at Mansa General Hospital of Luapula province of Zambia.Methods: We carried out a descriptive cross-sectional study of 66 women’s medical records who requested termination of pregnancy in 2018 January and 2019 December. The records were retrieved from Mansa General Hospital in Luapula province, Zambia. The case notes and consent forms were used to determine the characteristics and the reasons women requested a termination of pregnancy.Results: Out of the 66 retrieved records of women who requested a termination of pregnancy from the registry of the hospital, 58 had their request of a termination of pregnancy successfully done and 8 never went further to terminate their pregnancy while 1 of the 66 records had the information missing on whether their request was met or not for a termination of pregnancy.Mean age was 25 (SD 7.3) with a minimum of 13 and maximum of 44. Average gestation age was 7.5 weeks (SD 2.8). Fifty percent (50%) of women had one living child and 32.7% were married. Forty one percent (41%) were in their first pregnancy. Sixty eight percent (68.2%) of patients had secondary education whereas 27.3% had a tertiary education. Median parity was 2. The commonest reason for termination was the need to advance in education (27.5%). The second was poor economic home situation (20.3%). The third was medical reasons(13.0%).Conclusion: Based on the results of the study, the authors suggest strategies to increase knowledge of abortion rights and services and to improve the quality and accessibility of abortion services in Zambia