Mid Sweden University

Unsafe abortion is a major cause of maternal mortality in Kenya. There are significant barriers to access quality reproductive health care due to ambiguity in interpretation of the law, socioeconomic factors and stigma surrounding abortion. The aim was to investigate procedures of self-induced abortion used prior to seeking post-abortion care services, and predictors for self-induced abortion, among women in western Kenya. A cross sectional study was performed, with data collected by questionnaires from a randomized controlled trial executed in 2013-2016. In total, 805 women were included, of which 57 women reported self-induced abortion. This formed two groups and differences between them were investigated using descriptive statistics and a binary logistic regression. Marital status, employment and parity differed significantly between the groups, but not education level. Most (43.1%) used misoprostol to induce abortion, and many performed the abortion at home (39.6%), hence an unsafe setting. Traditional healers were involved in 14.6% and herbs by 35.3%. A higher percentage in the self-induced abortion group did not receive contraceptive counselling (7.5%) compared to the other group (1.8%). Being single was associated with a higher risk of self-induced abortion. Despite knowledge of risks, women chose an unsafe abortion most probably in the strive for nondisclosure. This study highlights the methods and settings used in selfinduced abortion. Knowledge of these processes contribute with information for larger health-care interventions to prevent unsafe abortions.