Determinants of induced abortion among second-trimester pregnant women attending Dessie City health facilities, Northeast Ethiopia: a case-control study

Introduction: Globally, 10-15% of induced abortions occur in the second-trimester period, over half of which is considered unsafe, and disproportionately contribute to maternal deaths.However, there are limited information about determinants of induced abortion in second-trimester in the country, particularly in the study area.Therefore, this study aimed to identify determinants of induced abortion in the second-trimester. Material and methods:Unmatched case-control study was conducted in Dessie City Northeast Ethiopia from January to March 2019.A total sample of 390 patients were included in the study, with a ratio of 1 : 2 (case : controls).Data were assessed in Epi data version 3.1 and analyzed with SPSS version 25.Multivariable logistic regression model was applied to identify determinants of induced abortion.Adjusted odds ratio with 95% confidence interval (CI) was used to measure the effect size of predictors. Results:The mean age of cases was 25 years ( 6.6) and 29.3 years ( 5.3) of controls.Seventy six (58.5%) cases were not currently married compared with 19 (7.3%) controls.Study participants who were currently not married (AOR = 10.82;95% CI: 5.01-23.36%),having poor knowledge about induced abortion (AOR = 3.03; 95% CI: 1.46-6.26%),uncertainty about last normal menstrual period (AOR = 4.12; 95% CI: 2.01-8.44%),late pregnancy testing (AOR = 5.94; 95% CI: 2.5-14.15%),not using contraceptives (AOR = 3.70; 95% CI: 1.85-7.44%),having irregular menstrual cycle (AOR = 4.83; 95% CI: 2.41-9.70%),and three and more live births (AOR = 0.25; 95% CI: 0.11-0.59%)were independent predictors of induced abortion in the second-trimester.Conclusions: This study identified several factors correlated with women having induced abortions in the second-trimester.It may be helpful for the government of Ethiopia to encourage the effort to improve healthcare counselling on reproductive health-related issues, and planning of interventions focusing on behavioral changes and social marketing as well as providing information to young adolescents on their sexuality to minimize pre-marital sex.