Assessing abortion safety among young women in Ghana: a sociodemographic and spatial study

Recent literature on induced abortion indicates a departure from the binary safe and unsafe classification of abortion methods to a more nuanced distinction between types of abortions as safe, less safe and least safe. This study assesses predictors of induced abortion safety among 1,561 women aged 15–34 years with experience of induced abortion and map the spatial distribution using data from the 2017 Ghana Maternal Health Survey. Multinomial regression analyses reveal that mother's age, zone of residence, number of living children and number of abortions are significantly associated with the relative odds of having safe or less safe abortions compared to least safe abortions. Spatial distributions indicate less and least safe abortions are densely concentrated in urban areas, where the incidence of induced abortions is also higher. The dominant abortion methods across 11 of the 16 regions is least safe, with the remaining five regions recording higher rates of less safe abortions. Thus, relevant stakeholders must seek to promote safe abortions, target the root causes of less and least safesafe abortion - unintended pregnancy, poor access to health services and comprehensive abortion care - and address the underlying sociodemographic and spatial disparities.