ASSESSMENT OF ABORTION TYPES AND ITS COMPLICATIONS WITH ITS

OUTCOME AMONG WOMEN WHO WERE ADMITTED FOR ABORTION AND POST
ABORTION CARE IN GAMBELLA GENERAL HOSPITAL, GAMBELLA TOWN,
ETHIOPIA

NILE COLLEGE GAMBELLA

COLLEGE OF HEALTH SCIENCES

DEPARTMENT OF MIDWIFERY

PRINCIPAL INVSETIGATOR: KIM JOCK RUACH

ADVISOR: KUOL DENG WANG (BSC, MPH)

A PROPOSAL RESEARCH PAPER SUBMITTED TO DEPARTEMENT OF

MIDWIFERY, COLLEGE OF HEALTH SCIENCES, NILE COLLEGE GAMBELLA IN A
PARTIAL FULLFILMENT OF THE REQUIREMENT FOR THE DEGREE OF
BACHELOR SCIENCE IN MIDWIFERY

GAMBELLA, ETHIOPIA

November, 2022

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Abstract
Background: Abortion is a sensitive and contentious issue with religious, moral, cultural,
and political dimensions. It is also a public health concern in many parts of the world. More
than one-quarter of the world’s people live in countries where the procedure is prohibit
permitted only to save the woman’s life. Yet, regardless of legal status, abortions still occur,
and nearly half of them are performed by an unskilled practitioner or in less than sanitary
conditions, or both.

Objective: The general objective of this study will be to assess the abortion types and its
related complication with their outcomes among women who were admitted for abortion and
post abortion care in Gambella General Hospital from November 2022 to April 2023

Method: The cross sectional study design will be used for both primary and secondary data
from November 2022 to April 2023 to assess abortion types, complication and its outcome
among all women who comes for abortion. The data will be collected from recorded
documents by using structured questionnaires by the data collectors together with Principal
Investigator. The source of and study population will be individual who visit Gambella
General Hospital before and during data collection period respectively. The data analysis
will be done by using Microsoft Office like Excel to describe the data using table bar and pie
graphs for data visualization.

Key word: abortion type, abortion complication, Gambella General Hospital, abortion
outcome.

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Table of Contents
Abstract.......................................................................................................................................................
ACKNOWLEDGMENT.............................................................................................................................
ACRONOYMY AND ABREVATION......................................................................................................
List of Figure.............................................................................................................................................
List of Table.............................................................................................................................................
CHAPTER 1: INTRODUCTION................................................................................................................
1.1. BACKGROUD OF THE STUDY....................................................................................................
1.2 STATEMENT OF THE PROBLEM...............................................................................................
1.3. Significant of the study.....................................................................................................................
CHAPTER TWO.........................................................................................................................................
2.1 Literature review...............................................................................................................................
2.1.1. Socio-demographic factors........................................................................................................
2.1.2 Types of abortions and their complication..................................................................................
2.1.3 Outcomes of abortion related complications...............................................................................
CHAPTER THREE: OBJECTIVES...........................................................................................................
3.1 General objective...............................................................................................................................
3.2 Specific objectives.............................................................................................................................
CHAPTER FOUR: METHODOLOGY.......................................................................................................
4.1 Study Area and Periods.....................................................................................................................
4.2 Study design and Period..................................................................................................................
4.3 Population..........................................................................................................................................
4.3.1 Source population.....................................................................................................................
4.3.2 Study population.......................................................................................................................
4.4 Inclusion and Exclusion criteria.......................................................................................................
4.4.1 Inclusion criteria......................................................................................................................
4.4.2 Exclusion criteria......................................................................................................................
4.5 Sample size determination...............................................................................................................
4.6 Sampling Procedure and technique..................................................................................................
4.7 Study variables................................................................................................................................
4.7.1 Dependent variables.................................................................................................................
4.7.2 Independent variables...............................................................................................................
4.8 Data collection.................................................................................................................................

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 4.8.1 Data collector...........................................................................................................................
4.8.2 Data collection tool..................................................................................................................
4.8.3 Data collection method.............................................................................................................
4.9 Data quality control.........................................................................................................................
4.10 Data processing and analysis plan.................................................................................................
4.11 Dissemination and utilization of results.........................................................................................
4.12 Ethical consideration..................................................................................................................
4.13 Operational definitions..................................................................................................................
Chapter 5: Work Plan and Budget.............................................................................................................
References.................................................................................................................................................
ANNEX 1: QUESTIONNAIRE................................................................................................................

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ACKNOWLEDGMENT
First and for most, we would like to thank our almighty God that lets us to do all these works
and allow us to reach at the final stage of doing the research paper. In addition to this, we
would like to appreciate our family and right friends for their unforgettable assistance by
providing all inputs which can help us to achieve our goal. And we will give our heart-fully
gratitude to our advisor, his carefully advising.

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ACRONOYMY AND ABREVATION
DIC Disseminated Intravascular Coagulation

E/C Evacuation and Curettage

IUCD Intra Uterine Contraceptive Device

KM Kilo Meter

M Meter

AGH Gambella General Hospital

MVA Manual Vacuum Aspiration

PAC Post Abortion Care

PI Principal Investigator

SMMC Sever Maternal Medical Condition

UK United Kingdom

WHO World Health Organization

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List of Figure

Figure 1 Work plan description.................................................................................................................

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List of Table
Table 1 Cost of stationary..........................................................................................................................
Table 2 Summary of the total budget.........................................................................................................

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CHAPTER 1: INTRODUCTION

1.1. BACKGROUD OF THE STUDY

Abortion is a sensitive and contentious issue with religious, moral, cultural, and political
dimensions. It is also a public health concern in many parts of the world. More than one-quarter
of the world’s people live in countries where the procedure is prohibit permitted only to save the
woman’s life. Yet, regardless of legal status, abortions still occur, and nearly half of them are
performed by an unskilled practitioner or in less than sanitary conditions, or both [1].

Worldwide, each year more than 500,000 women, 99% of them in developing countries, die
from pregnancy and childbirth-related complications and an additional 15 to 20 million women
suffer from debilitating consequences of pregnancy. The major causes of maternal deaths are
hemorrhage, infection, obstructed labor, hypertensive disorders in pregnancy, and complications
of unsafe abortion. Maternal deaths due to unsafe abortion in developing countries fall within a
narrow range from 9% to 17% of all maternal deaths [2].

In sub-Sahara Africa, more than 77% of induced abortions are terminated in unsafe conditions
and account for 50% of maternal death, with the abortion rate in sub-Sahara Africa almost
doubling from 4.3 million to 8.0 million between 2019, 2021 and 2022 [3, 2]. In some countries,
unsafe abortion is the most common cause of maternal death. It is also one of the most easily
preventable and treatable condition. In Africa, the risk of dying after unsafe abortion is one in
hundred fifty. Unsafe abortion attribute to 4.7-13.2% of global maternal deaths [4].

In Africa 60% of unsafe abortions generally occurs in women below age 25 years and 40%
occurs in the adolescent age group. Based on this evidence, evaluation of post-abortion care is
required to ensure up-to-date health care of young women of reproductive age in African settings
[5].

International awareness of abortion increased following the 1987 Safe Motherhood Conference
in Nairobi that drew attention to the need to reduce maternal mortality and morbidity. In many
developing countries, giving attention and solving the problem of abortion is a low priority for

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the health service managers. Unsafe abortion is not only a medical problem but also a social
problem. Different sectors should be involved in solving this problem [7].

In East Africa, the annual abortion rate for all women of reproductive age (15-49 years) is 34 per
1,000. Ethiopia has the world’s fifth-highest rate of maternal mortality, with one in every
twenty-seven women dying each year from pregnancy and childbirth complications [8].

Ethiopia is one of the low-income countries in sub-Sahara Africa with highest maternal
morbidity and mortality rates. The maternal mortality rate in Ethiopia was 412 maternal deaths
per 100,000 live births, according to the 2016 Ethiopia Demographic and Health Survey (2016
EDHS) [4, 9].

It is estimated that there are 3.27 million pregnancies in Ethiopia every year, of which
approximately 500,000 end in either spontaneous or induced abortion. In 2005, Ethiopia
expanded its abortion law, which had previously allowed the procedure only to save the life of a
woman or protect her physical health.

Currently abortion is liberalized in Ethiopia under certain preconditions that include cases of
rape, incest or fetal impairment, if the pregnancy endangers her or her child’s life, or if
continuing the pregnancy or giving birth endangers her life. A woman may also terminate a
pregnancy if she is unable to bring up the child, owing to her status as a minor or to a physical or
mental infirmity. Despite the implementation of the new law, almost six in ten abortions in
Ethiopia are unsafe [5].

1.2 STATEMENT OF THE PROBLEM

Worldwide approximately 20 million unsafe abortions performed each year, resulting nearly
80,000 maternal deaths and hundreds of disabilities. In Africa the risks of dying after unsafe
abortion is one in hundred fifty. Several studies indicated that unsafe abortion accounts for up to
25-35% of maternal deaths in Ethiopia being a critical public health problem with possible
complication like hemorrhage, sepsis, incomplete abortion and damage to internal organs [10, 6].
The mortality and morbidity risks of induced abortion depend on the facilities and the skill of the
abortion provider methods used and certain characteristics of the women herself such as general
presence of reproductive tract infections, STI, age parity and stage of the pregnancy. Unsafe

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abortion and its consequences impose heavy economic and health burdens on women and society
(11, 12).

Unsafe abortion accounts for around 70,000 deaths worldwide (13 percent of all pregnancy-
related deaths) and an estimated 5 million women are hospitalized for the treatment of serious
complications related to abortion, such as sepsis or hemorrhage, with many suffering long-term
ill-health as a consequence. The vast majorities (95-97 percent) of these deaths occurs in the
world’s poorest countries, and are at their highest in Africa. Almost half of all unsafe abortion
deaths occur amongst adolescents, girls under the age of 19 [13].

In Africa, Over 40% of the total deaths due to unsafe abortion have occurred making it the
leading cause of maternal mortality in the region. Unsafe abortion was recognized as a major
public health problem at the International Conference held on Population and Development
(2015) G.C and participants called for prompt, high quality and sympathetic medical services to
treat the complications of unsafe abortion. Additionally, they have called for compassionate post-
abortion counseling and family planning services to promote reproductive health and prevent
repeated abortions [14].

Problems related to abortion were neglected and access to quality post-abortion care was very
limited. Complications resulting from unsafe abortion are major public health problem in the
country which affects all women in reproductive age. Significant proportion (45%) of women
seeking care for abortion related complications are adolescent girls. Majority of health facilities
were not providing post-abortion care services and where available services were delivered in
un-integrated setup and ill-equipped facilities. Until the year 2014 G.C the law on abortion
related issues was one of the very restrictive in the world denying women accessing safe abortion
services [15, 8].

Post-abortion care [PAC] is treatment and counseling for post-abortion women. It includes
curative care, such as treating abortion complications, as well as preventative care, such as
providing birth control to prevent future unwanted pregnancies. Post-abortion care reduces
morbidity and mortality associated with abortion. [16, 17]

Prevalence of PNC approximately 75 million women required post-abortion care annually

following induced and spontaneous abortion (miscarriage) [18]. All countries have committed to

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reducing pregnancy-related mortality by providing treatment for abortion complications,
regardless if the abortion was illegally obtained [17]. Previously only 13.0% of public health
facilities in the Gambella General Hospital were provided the services. From facilities which
were providing the services, only a quarter were able to provide uterine evacuation using MVA
and they were heavily dependent on shape curettage. Provision of post abortion contraception
was practiced only by below a quarter of health facilities [19].

1.3. Significant of the study

Abortion is one of the commonest causes of maternal death particularly in developing countries
like ours. So, our study will show the specific types of abortion and related complications in the
study area and also it will also initiates other interested people to do further research on the same
topic. The study will also help stakeholders to create awareness to the community on how big the
problem and it impact to the life of the individual.

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CHAPTER TWO

2.1 Literature review

The World Health Organization (WHO) estimates that worldwide 210 million women become
pregnant each year and that about two-thirds of them, or approximately 130 million, deliver live
infants. The remaining one-third of pregnancies ends in miscarriage (spontaneous abortion),
stillbirth, or induced abortion. Abortion can be classified as Safe or Unsafe. Again, World Health
Organization defines an unsafe abortion as a procedure for terminating an unintended pregnancy
either by persons lacking the necessary skills or in an environment lacking the minimal medical
standards or both. When abortion is performed by qualified people using correct techniques in
sanitary conditions, it is very safe. Of the estimated 42 million induced abortions each year,
nearly 20 million are performed in unsafe conditions and/or by unskilled providers and result in
the deaths of an estimated 47,000 girls and women. This represents about 13 percent of all
pregnancy-related deaths. Almost all unsafe abortions take place in developing countries, and
this is where 98 percent of abortion-related deaths occur [2].

2.1.1. Socio-demographic factors

In Asia, 70 percent of unsafe abortions are among women 25 and older; many of them already
have children and want to limit family size. In Latin America and the Caribbean, more than half
of unsafe abortions occur among women who are in their 20s, suggesting that women in this
region use unsafe abortion to space births and limit family size. Nearly 60 percent of women in
sub-Saharan Africa who have unsafe abortions are younger than 25, and 25 percent are still in
their teens [13, 21]. It is estimated that in several Africa countries, up to 70 percent of all women
who receive treatment for complications of abortion are less than 20 years of age [25, 26]. More
than half (57%) lived in an urban or peri-urban area. A substantial proportion (42%) reported
having no formal education [20].

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6|Page
2.1.2 Types of abortions and their complication
Research done in Thailand shows that bleeding (48.7%) and pain (36.9%) were the commonest
symptoms in all methods reported by women had an unsafe abortion and complications
commonly occurred are retained conceptive products (74.7%) , pelvic infections (40%), need to
blood transfusion (10.4%), acute renal failure (3.5%), hypovolemic shock (5.8%), septic shock
(4.7%), DIC (1.1%) and death (1.1%) [19]

Deaths and disabilities related to unsafe abortion are difficult to measure due to hiding the report
of illegal procedures. In general, approximately 47,000 pregnancy related deaths are due to
complications of unsafe abortion (62% of this occurred in Africa). 5 million women are
estimated to suffer disability as a result of complication due to unsafe abortion. Unsafe abortion
procedures may involve insertion of an object or substance (root, twig or catheter or traditional
concoction) in to the uterus, dilatation and curettage performed incorrectly by unskilled provider;
ingestion of harmful substances; application of external force and incorrect dosage and mixture
of medications for inducing abortion. Complications of unsafe abortion include hemorrhage,
sepsis, peritonitis and trauma to the cervix, vagina, uterus and abdominal organs. About 20- 30%
of unsafe abortions cause reproductive tract infections and 20-40% of these result in infection of
upper genital tract. One in four women who undergo unsafe abortion is likely to develop
temporary or lifelong disability requiring medical care [18, 22].

Research done in Southern Ethiopia shows that 25% of abortions are induced abortion. From the
total induced abortions 73.5% occurred in urban and 26.5% in rural area and the majority of
women is in the age group of 20-24 [17].

Spontaneous abortion or Miscarriage is the most common reason for gynecological admission in
the Gambella General Hospital. The most sensitive studies suggest that with the fertile couples
pregnancy occurs in at least 60% of natural cycles. The studies also suggest that as many as 50%
of pregnancies miscarriage before implantation in womb occurred. Early after implantation
(before a pregnancy is clinically recognized) pregnancy loss rate is around 30%. And even after
the pregnancy is clinically recognized as many as one quarter of pregnancies miscarry, usually
during the first 14 weeks. Miscarriage risk rises as maternal age increases. For women under 35

7|Page
years the clinical miscarriage rate is 6.4%, at 35-40 years it is 14.7%, and over 40 it is 23.1%
[13, 24].

About a fifth (26 per 1000) of all pregnancies ended in induced abortion worldwide [15].
Reasons for seeking abortion are varied. Socio economic concerns (including poverty, no support
from the partners and disruption of education or employment); family building preferences
(including the need to post pone child bearing or achieve a health spacing between births);
relationship problem with the husband or partner; risk to maternal or fetal health; and pregnancy
resulting from rape or incest [16].

2.1.3 Outcomes of abortion related complications

Worldwide, some 5 million women are hospitalized each year for treatment of post abortion-
related complications, and abortion related deaths leave 220,000 children motherless [22].

The speed with which women receive treatment after arriving at a health facility is affected by
stuff attitudes. Currently women seeking care for abortion complications are often the last to
receive treatment only after all other patients have been treated [23].

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CHAPTER THREE: OBJECTIVES

3.1 General objective

The general objective of this study is to assess early abortion types and its related complication
with their outcomes among women who were admitted for abortion and post abortion care in
Gambella General Hospital from November 2022 to April 2023.

3.2 Specific objectives

The specific objectives of this study is to:

1. Identify the specific types of abortion among the admitted women in Gambella General
hospital
2. Assess abortion related complications among the admitted women in Gambella General
hospital
3. Review women’s outcome after abortion among the admitted women in Gambella
General hospital

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CHAPTER FOUR: METHODOLOGY

4.1 Study Area and Periods

The study will be conducted in the Gambella region Gambella General Hospital and carried out
from November 2022 to April 2023 which is situated 766km South Western part of the capital
city Addis Ababa. The climate it is found at an attitude of 10 degree 19, 60.00’’N and longitude
of 34 degree 39.59,99’’E and an elevation of 1975 meter above sea level. Have an annual
average rain fall ranges of 1600ml. The majority ethnics group in this zone is Nuer and Anuak
people. In Gambella Town there is one General hospital, one Primary Hospital two health
centers, and 75 private clinics. Gambella General Hospital was established in 1992 with total of
91 staffs and currently in hospital has a total of 236 staffs nurses, 30 midwives, 29 health
officers, 11 pharmacists, 11 practices, 8 radiography, 2 laboratory technologist .It gives service
to the inhabitants of the region with the addition to Gambella Town Primary Hospital . The
hospital provides health service Under OPD and emergency, ANC, Pediatrics, MCH, delivery,
gynecology and NICU as well as IPD and family planning services. Now the hospital has four
wards namely medical, surgical, OB/GYNE and pediatrics wards. According to 2015 census
Gambella town health statics reports the estimated total population is 42,983 of whom
21,234[44.4%] are men and 21,749[50%] are women. The total number of women in
Reproductive Age Group [15-49 years] are 14,248 which among 33.1% of the total population
(4).

4.2 Study design and Period

Cross sectional study design will be used to assess the types of abortion and its complication
and its outcomes among the women who come for abortion and post abortion care in Gambella
General Hospital from November 2022 to April 2023

4.3 Population

4.3.1 Source population

The source population of this study will be women who attended Gambella General
Hospital for abortion and post abortion service from November 2022 to April 2023

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 4.3.2 Study population
The study population will be the women/individual who came to utilize abortion and Post
Abortion Services in Gambella General Hospital from November 2022 to April 2023

4.4 Inclusion and Exclusion criteria

4.4.1 Inclusion criteria

- The women who utilized abortion and post abortion service in Study area will be
included in the study

4.4.2 Exclusion criteria

- Those women whose medical chart is lost.

- Those women who were registered in the abortion register with incomplete data will
be excluded from the study.

4.5 Sample size determination

The sample size will be determined by using single population proportion formula with the
following assumption; 17.4% of prevalence of previous studies conducted in Gondar town 2015,
95% confidence interval, 5% margin of error, 10% for non-response rate due to this. Therefore,
the sample size of this study will be expressed as follow:

n=Za/22 p (1-p)/d2

n=1.962*0.174(1-0.174)/0.052

n=221

Since our source population is 1548, which is less than 10000; correction factor formula will be
used.

n= n/ (1+n/N) = 221/(1+221/1548)

By adding non-response rate, 10% our sample size is 243.

Where, n= the required sample size

N= source population

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 n= new sample size

Z= standard score corresponding to 95% confidence interval

P= population proportion=17.4%

D= margin of error (precision) 5%

4.6 Sampling Procedure and technique

After calculating the sample size the study participates will be selected by used convenience
(accidental) sampling technique which involves women who come to attended Gambella general
hospital for abortion and post abortion service during data collection period. Since we have N=
1548, n=243 then we got K= Estimated total population in study period/ Determined sample size.

K= 1548/243=6.37 = 6

Then the sample will be selected to get the require sample in the following sequence 1, 7, 14, 21
or after started from the first client randomly until the required sample size is attained.

4.7 Study variables

4.7.1 Dependent variables

 Types of abortion and
 Complication with its outcome.

4.7.2 Independent variables

- Age of mother - Occupation - Ethnicity

- Age of child - Marital status - Mother Education level

- Father education level - Income - Number of children

- Decision making ability - Religion

- Obstetrics factors like gravidity and parity.

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4.8 Data collection

4.8.1 Data collector

- The required data will be collected by the principal investigators with help of Health
Practitioner within the Hospital.

4.8.2 Data collection tool

A data collection will be in the form of structured questionnaire with both closed ended in
English and Amharic Language .The tools will inquired the intended data like socio demographic
of the participants, types of abortion, related complication and outcome and others characteristics

4.8.3 Data collection method

Data will be collected by document review for secondary data and written questionnaire for
primary data. Data collectors will be trained for data collection process and the very objective of
the questionnaire. The data will be collected from medical records by using a check list prepared
to retrieve required data this is will be true for secondary data.

4.9 Data quality control

A group discussion will be done among the data collectors in order to have a common
understanding on the tool. Meanwhile, the quality of the data will be assured by checking for
consistency and completeness by the Principal Investigators. Pre- test of 5% of the total eligible
sample will be conducted in the Gambella Primary Hospital before the actual data collection
period.

4.10 Data processing and analysis plan

The collected data will be processed and analyzed by using tally sheet, manual scientific
calculator, paper, pencil and pen. The analyzed data will be presented using frequency
distribution tables, pie charts and figures for data visualization.

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4.11 Dissemination and utilization of results
The result of the study will be submitted to Nile College Health science, department of
Midwifery for documentation in the department. The result will be presented in form of a
written report documents to the Chief Executive Director CEO in the Gambella General Hospital

4.12 Ethical consideration

The permission letter will be obtained from Nile College Research Committee and will be
submitted to Gambella General Hospital. The study participants will be informed verbally about
the purpose of the study along with their right to refuse and their data will be keep confidentially
solely for research purpose.

4.13 Operational definitions

o Abortion is termination of pregnancy before maturity.
o Spontaneous abortion is the passing of a pregnancy without intervention.
o Threatened abortion is bleeding of intrauterine origin without expulsion of the products
of conception and there is chance of continuation of pregnancy.
o Complete abortion is the expulsion of all of the products of conception.
o Incomplete abortion is the expulsion of some, but not all, of the products of conception.
o Inevitable abortion refers to bleeding of intrauterine origin without expulsion of the
products of conception but, there is no chance of continuation of pregnancy.
o Missed abortion, the embryo or fetus dies, but the products of conception are retained the
uterus.
o Septic abortion, infection of the uterus and sometimes surrounding structures occur.

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Chapter 5: Work Plan and Budget
Figure 1 Work plan description

Year Dec 2022 to April 2023 G.C

Activities
Responsible body Nov Dec Jan Feb Mar April

Title selection PI
Proposal writing and
approval
Data Collection Data Collectors
Entry and Analysis PI
Interpretation of Result PI

Research Paper Writing PI

Submission PI

Presentation PI

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Table 1 Cost of stationary

No Items Unit Quantity Unit cost Total cost

Birr Cents Birr Cents
1 Paper Pack 2 200 00 400 00
2 Pen Doze 01 300 00 300 00
3 pencil Pcs 01 20 00 20 00
4 Ruler Pcs 1 20 00 20 00
5 Photo copy Pcs 50 3 00 150 00
6 Printing Pcs 100 5 00 500 00
Sum total 1,390 00

Table 2 Summary of the total budget

No Items/Activities Cost (ETB) Remarks

1 Work Force Cost 1000 00

2 Miscellaneous expense 500 00

5 Stationery costs 1,390 00

6 Transportation cost and Per diem 500 00

7 Subtotal 3390 00
8 Contingency (10%) 339 00
Total cost 3,729 00

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References
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Medicine and Medical Science Research, 2022, Addis Ababa.
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the incidence Of Unsafe Abortion And Associated Mortality In 2003, 5th edd. (2007).
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14. WHO, Unsafe abortion: the preventable pandemic, journal paper of sexual and
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Geneva: WHO 2008)
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Med Assoc Thai 2011; 94 (4): 408-14)
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Nigeria: International journal of nursing and Midwifery;6(2), 26, April, 2014)

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ANNEX 1: QUESTIONNAIRE
Section I: Socio- demographic questions

1. Age
2. Sex

Section II: Selected obstetrics characteristics questions

3. Gravidity_______________
4. Gestational age___________________

Section III: Assessment of Abortion

5. Is the mother had previous abortion? (A) Yes b. No

6. If yes, how many times? 1_______2________3_________>3_________
7. Which type of abortion? A Spontaneous B. induced
8. If spontaneous, which type of abortion did she have?

A Complete b. Incomplete c. Inevitable d. Threatened e. Missed f. Septic g. Other

9. If induced, what was the indication? (A) Rape Incent (B) SMMC (C) Incompatible to
life
10. Which type of abortion she had currently? A spontaneous (B). induced
11. If spontaneous, which type? A. Complete B. Incomplete c. Inevitable d. Threatened
(E)Missed f. Septic g. Other
12. If induced, what was the indication? (A) Rape (B). Incent (C). Incompatible to life
(D)serious maternal medical problem
13. What intervention was undertaken? (A) Medical___(B)Surgical______(C)
Both___(D)None___________
14. If surgical, what kind? (A). MVA (B). D/C (C). E/C (D). Hysterectomy
15. If medical, what kind? A Mifeprostol B Misoprostol C Both

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 16. Who did the intervention? (A). Senior (B).Emergency Surgeon (C)Trained Midwife
(D)Other (specify):_______________________________

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Section IV: Complication and outcome

17. Is the mother had any complication? (A) Yes (B). No

18. If yes, what was it? (more than one is possible) Bleeding b. Infection c. Perforation d.
Anemia e. Shock f. Other(specify):______________________________
19. If she has, where did she go for treatment? (A) At home (B). Health Institution
(C)Others ( specify)___________________
20. What was the outcome of the mother? (A) Death (B). Improved (C)Disabled
(D)specify):____________________________

Section V: Post abortion care

21. Was the woman counseled about post abortion FP utilization? (A) Yes (B). no
22. Did the mother gain post abortion family planning? (A) Yes (B) No
23. If Yes, What type was it? (A) IUD (B). Condom (C). Implanon (D). Injectables
(E)Pills (F). Jadelle (G) Others (specify):_________________________________

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