Determinants of Repeat Abortion among Patients Seeking Post Abortion Care Services in Eastern Uganda
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Date
2026
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Busitema University
Abstract
Maternal mortality remains a global health concern, with Uganda recording a maternal mortality ratio of 189 per 100,000 deliveries, which is above the Sustainable Development target of less than 70. Unsafe abortion contributes greatly to this burden, which accounts for approximately 6-8% maternal mortality in the country. Moreover, repeat abortion (RA) is one of the persistent challenges for healthcare systems worldwide and addressing it remains a significant challenge that requires a targeted approach. Uganda has abortion related severe morbidity, near-miss, and mortality ratios of 2063, 938 and 23 per 100, 000 live births, respectively. Repeat abortion is a public health challenge that needs to be investigated. Despite the existence of this problem, there is a dearth of literature regarding the prevalence and determinants of repeat abortion in Uganda, especially in the eastern region.
Materials and methods. The study employed a non-matched case-control study design in three selected health facilities in eastern Uganda. A total sample size of 366 study participants (122 cases and 244 controls) was recruited. Controls were recruited by simple random sampling, and the cases by a consecutive sampling technique. Data were entered into MS Excel 2010 and cleaned for missing values, outliers, and inconsistencies. Coded data were then exported to Stata version 15 for analysis. Descriptive statistics, including means, percentages, frequencies, and standard deviations, were used to summarize participant characteristics. Associations between categorical variables were tested using the chi-square test, while an independent t-test was used for continuous variables. Multivariable logistic regression was performed to identify predictors of the outcome while controlling for confounders. Statistical significance was set at p<0.05 with 95% confidence intervals reported. Results of the 366 participants, 33.3% (122/366) were cases (“repeat abortion”) while 66.7% (244/366) were controls (“index abortion”). The mean age of cases was 27years while that of controls was 24 years. The majority of the controls reported unplanned pregnancy, 68.4% compared to 56.6% for the cases. Notably, whereas 72.9% of the controls had early sexual debut, 67.2% among the cases did so. Additionally, there was low utilization of modern contraceptives across the board, with only 27.1% of the cases, 36.5% for the controls. The study found statistically significant associations between advanced maternal age and higher odds of repeat abortion (AOR: 9.42 95%CI: 1.82-48.67, p=0.007) with 30-34 years older women most affected. Symptoms preceding current abortion specifically malaria and urinary tract infections were significantly associated with repeat abortion (AOR: 3.2, 95%CI (1.81-6.01), p<0.001), Women who had a short interpregnancy interval had higher odds of repeat abortion compared to those who had the recommended or long interpregnancy interval (AOR: 0.32, 95%CI 0.18-0,57, p<0.001). Moreover, women whose preceding pregnancy ended in a stillbirth had substantially higher odds of suffering a repeat abortion, unlike those who had a live birth (AOR: 0.23, 95%CI 0.13-0.39, p<0.001), Unwillingness to use a modern contraceptive as part of the post-abortion care package was significantly associated with repeat abortion(AOR: 0.65 95%CI 0.51-0.82, p<0.001). No significant associations were observed with contraceptive use, having more than one partner, and a history of child abuse. In eastern Uganda, efforts to tackle repeat abortion should aim to target mothers of older mothers, encourage postpartum and post abortion modern contraceptives to prolong interpregnancy interval. In addition, early antenatal care attendance and screening for infections such as malaria, urinary tract infections and asymptomatic bacteriuria should be encouraged and emphasized.
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An undergraduate dissertation
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Citation
Mudimi, V. (2026). Determinants of repeat abortion among patients seeking post abortion care services in eastern Uganda [Undergraduate research report]. Busitema University.