title: Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis.
abstract: Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya.
  
  
  
  We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form.
  
  
  
  Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %).
  
  
  
  Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion care service providers must ensure that young clients receive contraceptive counseling and effective pregnancy prevention methods before discharge from the health care facility to prevent unintended pregnancies that may result in subsequent induced abortions.
authors.affiliation: African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya. carolinekabiru@gmail.com.|John C Caldwell Population, Health and Development Visiting Fellow, the National Centre for Epidemiology & Population Health (NCEPH) and School of Demography, Australian National University, 9 Fellows Road, Acton, ACT, 2601, Australia. carolinekabiru@gmail.com.
authors.forename: Caroline W
authors.initials: CW
authors.lastname: Kabiru
authors.affiliation: African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.|Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Boniface A
authors.initials: BA
authors.lastname: Ushie
authors.affiliation: African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.|School of Public Health, University of Witwatersrand, Wits Education Campus, 27St. Andrews Road, Parktown, 2193, Johannesburg, South Africa.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Mutua
authors.affiliation: African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.
authors.forename: Chimaraoke O
authors.initials: CO
authors.lastname: Izugbara
mesh_terms: D000028:Abortion, Induced / Q000523:psychology* / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007630:Kenya; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology*; D011275:Pregnancy, Unwanted / Q000523:psychology*; D012650:Self Disclosure; D055815:Young Adult
keywords: Contraception; Kenya; Multiple Induced Abortions; Sexual and Reproductive Health; Sub-Saharan Africa; Unintended Pregnancy; Young Women