Determinants of Repeated Induced Abortion among Women of Reproductive Age Seeking Post-Abortion Care in Addis Ababa, Ethiopia, 2022: Unmatched Case Control Study

Document Type : Original Research Article

Authors

1 Director, Department of Maternal and Child Health, Addis Ababa Health Bureau, Addis Ababa, Ethiopia

2 PhD, Department of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia

3 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Ethiopia

4 Associate Professor, Department of Emergency, Critical and Chronic Care, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Ethiopia

10.22038/jmrh.2025.75352.2214

Abstract

Background & aim: Repeated induced abortion (RIA) poses a significant risk to women's reproductive and mental health. Despite the high incidence of RIA in Ethiopia, there is limited analytical evidence, particularly using case-control designs, to identify its specific determinants among women seeking post-abortion care. This study aimed to investigate the determinants of RIA among women of reproductive age in public and private hospitals in Addis Ababa, Ethiopia, in 2022.
Methods: A hospital-based unmatched case-control study was conducted from June 1 to July 7, 2022. The sample included 336 women (112 cases:  ≥ 1 previous induced abortion; 224 controls: first-time induced abortion). Data were collected via interviews using semi-structured questionnaires. Logistic regression was used to identify factors, with statistical significance set at p < 0.05 (95% Confidence Interval, CI).
Results: The response rate was 100%. The strongest determinants of RIA were: alcohol consumption (AOR=20.8; 95% CI 9.0, 48.1), not using contraceptives after previous abortion (AOR=7.8; 95% CI 3.0, 20.4), no education (AOR=7.97; 95% CI 2.2, 29.5), sexual gender-based violence (AOR=7.15; 95% CI 3.1, 16.3), elementary school education (AOR=3.4; 95% CI 1.2, 10.1), and having multiple sexual partners (AOR=3.01; 95% CI 1.4, 6.4). Abortion due to rape (AOR=6.4) and unplanned sex (AOR=3.1) were also significant factors.
Conclusion: RIA in Addis Ababa is strongly associated with behavioral (alcohol consumption, multiple partners), social, and structural (low education, contraceptive non-use) factors. Interventions should integrate reproductive health services with targeted counseling for alcohol use, sexual gender-based violence screening, and enhanced, mandatory post-abortion contraceptive counseling, particularly for low-literacy women.

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References

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Journal of Midwifery and Reproductive Health
Volume 14, Issue 1
January 2026
Pages 5164-5173

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