CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background of the Study

According to WHO (2018) Abortion is defined as pregnancy interruption “before the fetus is viable” or “before the fetus is able to live independently in the extra uterine environment, usually before the 20th week of pregnancy”. Furthermore, (Jeje 2001) defined abortion as the discarding by the uterus of the product of conception before the 24^th week of pregnancy. Young women and girls account for nearly one-third of all abortion-related deaths each year worldwide, with 15% of all unsafe abortions taking place among adolescents and early adulthood ages 15- 30 (Shah, I.H. & Ahman, E. 2012). Despite growing global attention to the health and welfare of adolescents and girls, little is known about the abortion experiences of girls who undergo abortion.

Abortion also known as miscarriage is an age old practice carried out by human beings. It is practiced in all parts of the world though still widely illegal. The World Health Organization defines an unsafe or criminal abortion as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards or both. It could be also said that Criminal abortion is the termination of pregnancy in violation of law. (WHO 2008).

 The deliberate termination of a pregnancy has been known since ancient times. Various methods have been used to perform or attempt abortion, including the administration of abortifacient herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques (Brodie Janet Farrell 1997). Unsafe abortion is one of the neglected problems of health care in developing countries (WHO 2000). In fact, in most places, it is carried out in secrecy, which makes it difficult to determine the exact incidence of the condition. Recent estimates gives an overall figure of around 30 million induced abortions annually in the world (Kemfang NH et al., 2015). About 19-20 million of these abortions are done by individuals without the requisite skills or in environments below minimum medical standards or both. Nearly all unsafe abortions (97%) are in developing countries (Grimes DA et al., 2006). Abortion among adolescents and youth is a major public health issue, especially in developing countries. Estimates indicate that 2.2 million unplanned pregnancies and 25% (2.5 million) unsafe abortions occur each year, in sub-Saharan Africa, among adolescents (Guttmacher institute 2015). In 2008, of the 43.8 million induced abortions, 21.6 million were estimated to be unsafe, and nearly all of them (98%) took place in developing countries, with 41% (8.7 million) being performed on women aged 15 to 24 (Shah, I.H et al., 2008). The consequences of abortion, especially unsafe abortion, are well documented and include physical complications (e.g., sepsis, hemorrhage, genital trauma), and even death (Ahman, E et al., 2007). The physical complications are more severe among adolescents than older women and increase the risk of morbidity and mortality (Ahman, E et al., 2007). However, the detrimental effects of unsafe abortion are not limited to the individual but also affect the entire healthcare system, with the treatment of complications consuming a significant share of resources (e.g., including hospital beds, blood supply, drugs)

In Cameroon, the prevalence of induced abortion is about 25% (Tebeu PM et al., 2015). Furthermore, in 2000, the estimated maternal mortality ratio attributed to unsafe abortion in Cameroon was 90 to 100,000 live births (Kongnyuy EJ et al., 2007). This is a huge number which could be controlled if abortions were done safely. Unsafe abortion is responsible for 25% of maternal deaths in Cameroon (Tebeu PM et al., 2015); consequently, abortion is one of the leading causes of maternal mortality in Cameroon. As a result of these maternal deaths arising from abortion, there are ongoing debates on the liberalization of abortion in Africa generally and Cameroon in particular (Wonkam A et al., 2007). The law in Cameroon under the 2007 Penal Code (sections 337-339) stipulates that the performance of abortions is illegal except if proven necessary to save the mother from grave danger to her health or when the pregnancy is the result of rape. It continues that anyone performing an illegal abortion is subject to one to five years imprisonment and a fine of 100,000 to two million CFA francs. A woman who procures or consents to her own abortion is subject to imprisonment for fifteen days to one year and/or a fine of 5,000 to 200,000 CFA francs. Despite these harsh legal sanctions meted on those involved in the act such as 10 years of imprisonment and withdrawal of the certificate of medical practitioners, unsafe abortion is still on the rise. Clandestine abortion services are offered by lay abortionists, trained midwives and native doctors, out of view of the public health services which result in many cases of poorly performed abortions (Schustern S.2005).

1.2 Statement of Problem

Young girls of Ages 15- 30 years are a person’s youthful age and they tend to be very sexually active and in turn could lead to unwanted pregnancy and ends up in the girl having an abortion. In Cameroon and in many African countries, unsafe abortion is one of the contributors to high level of maternal mortality. With the increasing rate of criminal or unsafe abortion amongst young girls, the knowledge on the consequences of criminal abortion is relatively low. This prompted the need for the assessing the consequences of criminal abortion among young girls.

1.3 Justification     

Unsafe abortion is one of the contributors to high level of maternal mortality amongst adolescent and young girls in sub Saharan countries. Abortions are not rare in Cameroon, one fifth of Cameroonian teenage mother have had at least one abortion in the past (Adonis T et al., 2007). It is noted that most young girls who survive from unsafe abortion, could suffer from infection, infertility, sepsis etc. Tebeu et al reported over 25% of maternal deaths in a references hospital in Cameroon resulted from complications of unsafe abortion. Therefore this study aims to assess young girls knowledge on criminal abortion .

1.4 Research Objective

1.4.1 General Objective

The study aims to assess the knowledge of criminal abortion among young girls aged 15 to 30 years on abortion in the Muea Community.

1.4.2 Specific Objectives

1. To assess the knowledge of young girls aged 15 to 30 on criminal abortion in the muea community.
2. To find out why young girls aged 15-30 year go in for criminal abortion in the Muea Community?
3. To find out their knowledge on the complication of criminal abortion in the Muea Community.

1.5 Research Question

1. What do young girls aged 15-30 years know about abortion in the Muea Community?
2. Why do young girls 15-30 years go in for criminal abortion in the Muea Community?
3. What knowledge do young girls aged 15-30 years have about the complication of criminal abortion in the Muea Community?