title: Female autonomy and reported abortion-seeking in Ghana, West Africa.
abstract: OBJECTIVE
  To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision.
  
  
  METHODS
  In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior.
  
  
  RESULTS
  Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05).
  
  
  CONCLUSIONS
  Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services.
authors.affiliation: Global REACH, University of Michigan Medical School, Ann Arbor, USA. Electronic address: sarahrom@umich.edu.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Rominski
authors.affiliation: Global REACH, University of Michigan Medical School, Ann Arbor, USA.
authors.forename: Mira
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Jeffrey Cheah School of Medicine and Health Sciences, MONASH University, Sunway Campus, Subang Jaya, Malaysia.
authors.forename: Raymond
authors.initials: R
authors.lastname: Aborigo
authors.affiliation: Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana.
authors.forename: Phillip
authors.initials: P
authors.lastname: Adongo
authors.affiliation: Department of Pediatrics and Maternal Child Health, Schools of Medicine and Public Health, University of North Carolina, Chapel Hill, USA.
authors.forename: Cyril
authors.initials: C
authors.lastname: Engman
authors.affiliation: Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Ghana Health Service, Accra, Ghana.
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
authors.affiliation: Global REACH, University of Michigan Medical School, Ann Arbor, USA; Department of Medical Education, University of Michigan Medical School, Ann Arbor, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Moyer
mesh_terms: D000029:Abortion, Legal / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D008428:Maternal Mortality; D008875:Middle Aged; D026684:Personal Autonomy; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D019035:Rural Health Services; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019037:Urban Health Services; D016387:Women's Health
keywords: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal health; Reproductive health