Chapter one
INTRODUCTION

1.1    Background of the study

Abortion is a relatively used term. It is the word used to describe the act of termination of pregnancy by the removal or expulsion from the uterus of a foetus or embryo prior to viability. The term “Abortion” most commonly refers to the induced removal of human pregnancy. It could mean a plan or arrangement which takes place in the foetus before it can develop properly.
In Nigeria, as in all parts of the world, women experience unplanned pregnancy. Some of these women seek to terminate their pregnancies by safe medical methods or by other unorthodox methods available. The procurement of abortion is by no means a new phenomenon in Nigeria. The main reason why young girls and women procure abortion is always changing. Increasingly, women procure abortion due to desire to avoid premarital births and to control family size (Aboyeji, 2003).

However, abortion as it is used in this study is the act of terminating or stopping the development of a child in the womb of a woman either by medical operation or self medication.
Abortion, when induced in the developed world in accordance with local laws is among the safest procedures in medicine. Notwithstanding, unsafe abortion occurs in approximately 70,000 maternal death and 5 million cases of disabilities are recorded yearly, globally (www.wikipedia.com). Abortion is an age old practise, it was universally practised but not universally accepted. It was seen as a social evil, one that brought down the curse of the gods. The evil notion that primitive people heard about was so profound that it was believed in some tribes that abortion committed by a married woman could cause the husband to be sterile especially when the husband is not responsible (Olaitan, 2003).

The above reasons did not stop the practise of abortion among primitive people. Women in the olden days would rather have their pregnancy terminated than to have the child to be raised in slavery.  Pregnancies involving members of the same family were aborted because it was seen as a taboo. Lactating women who become pregnant had the pregnancies aborted to ensure the flow of milk for the living child. Primitive men used crude, traumatic and often ineffective means to terminate pregnancy which led to the deaths of the victims. Today, abortion continues to be practised whether forbidden or accepted for a variety of social, political, economic and religious reason that are not completely different from those given by primitive men (Boyd, 2006).

Over the years, due to advanced science and technology, man has been able to tackle problems more effectively than primitive men. Modern man has been able to eradicate lots of diseases from the face of the earth and invented easier and faster means of cooking and transportation which is seen as less primitive, why is he still very primitive in the way he solves the problem of unwanted pregnancies? Abortion is seen by many in the world today as immoral and ungodly, an act that calls for a punishment from both God and man. Many others still see abortion as a means of regulating the population and balancing the socio economic needs of the family. For this above reason, abortion has been the centre of many legal, social, political and religious debates in the countries all over the world (Jones, 2004).

Abortion is a life threatening issue, one that has claimed the lives of thousands of young women and girls all over the world, therefore, it is an issue that concerns everyone in the society no matter what your stand is on abortion. Consider a young girl of fourteen who gets pregnant and is desperate for a solution. Since she is unable to face the consequences of pregnancy at this age, she may not even know who is responsible for her pregnancy after realising she is pregnant due to obvious signs of pregnancy (nausea, insomnia, etc). She may decide to procure an abortion either on her own or with the aid of someone in order to cover shame. The image is frightening that a young girl of such a tender age, both physically, psychologically, and emotionally immature finds herself on an operating table where she gives her body and life to the sharp instrument of an abortionist.

On the other hand, this young girl may decide to procure an abortion herself or may find herself in the hands of quacks such as half-baked nurses, medical school dropouts, traditional medicine practitioners and other paramedical quacks which could lead to loss of life or sustenance of severe complications which may affect the womb. In this situation, who is to blame for her death? Is it her teachers, parents, peers, the young girl herself, the abortionist or the society at large? The plight of these young adolescents at this period of life is pitiable because they probably have been exposed to sexual intercourse at a very young age. They also may have indulged in sex without being aware of the consequences of their action which in fact speaks of ignorance and innocence.

Again, these young girls may have been lured into sex by older members of the community seeking pleasure. These individuals may deceive these young girls to engage in premarital sex. In whatever way abortion is performed on these young girls, whoever the abortionist is and whatever reasons these girls have to procure abortion, the fact still remains that these young girls are dying daily in their thousands and nothing has been done to remedy the situation.

1.2    Statement of the problem

Abortion has claimed the lives of hundreds of women and rendered many of them infertile in Big Qua Community due to its attendant effects and complications which include menstrual dsisorders rupture of the uterus or womb, recurrent abortion or miscarriages, septicemia, splitting of the cervix, adjacent organ damage, perforation of the uterus and even death. It is against this background that government has made provision for free antenatal care/services and treatment of the under fives so that women who are living with low income standard can afford medical services and retain their pregnancy to term.

In spite of all these services, it has been observed that women age 15 -49 years in Big Qua Community still indulge in abortion. From observation and data gathered, abortion in totality leads to perforation of the uterus, formation of adhesion thus resulting to menstrual disorders such as amenorrhea which eventually metamorphose to infertility or barrenness.

Consequently, it becomes pertinent to ask; could the refusal of women aged 15-49 years in Big Qua Community to stop abortion be due to lack of knowledge on the dangers associated with abortion or ignorance of the consequences in terms of infertility? An attempt to answer this question prompted the researcher to examine abortion and the health of females (15-49 years) in Big Qua Community, Calabar Municipal Area of Cross River State.

  1.3    Objectives of the study

The major objective of this study is to analyze the increase in mortality rate as a result of abortion among young women of childbearing age (15-45yeras) in Big Qua Community, Calabar Municipal Area of Cross River State.

The specific objective:

    To determine the effect of threatened abortion on the health of females (15-49 years).

    To find out the extent to which criminal abortion affect the health of females (15-49 years).

    To evaluate the effect of septic abortion on the health of female(15-49 years)

1.4    Research questions

    To what extent does threatened abortion affect the health of females (15-49 years)?

    How will criminal abortion affect the health of females (15-49 years)?

    How will septic abortion affect the health of females (15-49 years)?

 1.5    Significance of the study

          Findings of this study will be of immense benefit to doctors/nurses and all health workers, students and married women.To doctors/nurses, it will help them understand the reasons why women submit to abortions of any kind. This will provide information for the development of information education and communication (IEC) materials to effectively educate women and general public on abortion in general and the dangers of illegal abortions.

To students, it will enable them to understand why they should not indulge in abortion because of the short and long term complications and dangers associated with it. It will also enable them know the relationship between abortion and infertility.

To married women, the study will enlighten them on the consequences of abortion and equally provide hope for those who are already victims as new methods of achieving pregnancy/fertility are made known to them.

1.6    Delimitation of the study

This study is limited in the scope to abortion and effect on the health of women of childbearing age (15-45 years). It is also limited in scope to Big Qua Community in Calabar Municipal Area in Cross River State.

It is also limited to three major types of abortion which were adopted as sub-variables for this study as follows: threatened abortion, criminal abortion and septic abortion.

 1.7   Limitations of the study

In any meaningful undertaking, there are some problems that can hinder the speedy and successful completion of such a task. Therefore, major limiting factors in this work were ; the short time allotted for the completion of the work and the uncooperative attitude of some respondents to provide the researcher with necessary information. Since the researcher topic has some social implications.

 1.8   Definition of terms

For easy understanding of some medical terms used in this work, there is need to define them to ease clarification:

    Infertility: the inability of a couple to bear a living child despite living together and having unprotected sexual intercourse and wishing to have a child for at least one year

    Abortion: Is the termination of pregnancy before the embryo/feotus (baby in the womb) attain the age of viability (maturity)

    Threatened abortion: The condition in pregnancy before the 20th week marked by bleeding and cramping uterus sufficient to suggest that miscarriage may result.

    Criminal abortion: Illegal termination of pregnancy

    Septic abortion: Is a form of miscarriage that is associated with a serious uterine infection

    Fertility: The ability to procreate.

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