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Background: Repeat abortion is termination of pregnancy done more than one time which is usually a consequence of inadequate contraception and common occurrence among vulnerable groups such as adolescents. It an important public health concern especially in the developing world that increases maternal morbidity and mortality. It might have significant consequences for sexual and reproductive health and it is linked to long-term effects and risk of adverse birth outcomes increase with the additional number of abortions especially among adolescents. Repeated safe abortion can lead to increased odds of genital infections, prolonged bleeding, and postpartum death. Additionally, there is higher likelihood of psychological disorder, depression and adverse neonatal outcomes such low birth weight and preterm birth.
In Zambia, there is paucity of data about the magnitude and associated factors of repeat induced abortion among adolescents. Therefore, the aim of this study was to identify determinants of repeated induced abortion among adolescents aged 13 – 19 years seeking from selected public hospital, Lusaka, Zambia,
Methods: The study was an institution-based cross-sectional study conducted between October 2024 and February 2025 from selected 1st level hospitals in Lusaka, Zambia. Participants were consecutively enrolled and probability proportional to size was conducted according to the total number of women seeking induced abortion in each hospital during the study period. Data was collected using an interviewer-administered structured, and pretested questionnaire. Clinically, repeat induced abortion was considered when a woman reported having more than one induced abortion before the 28th week of pregnancy. Multivariate regression analysis was done to test strength of association between independent variables with repeat abortion among adolescents.
Results: A total of 154 respondents participated in the study, and the median age of adolescents was 18 years (IQR 16-19). The prevalence of repeat abortion among adolescent was 16.9% (95% CI:11.7- 23.7). The risk factors associated with repeat abortion included; history of multiple sexual partners (AOR=2.8, 95% CI 1.04 -7.11), residents of Chipata compound (AOR =3.0, 95% CI 1.22-7.5), previous contraception use (AOR=2.3, 95% CI 1.03-5.51) and adolescent that had a history of giving birth to a child (AOR= 4.33, 95% CI 1.69-11.4).
Conclusions: The prevalence of repeat abortion adolescent in the study is similar with findings from other studies in developing countries. The finding in the study suggests that the most vulnerable adolescents who received safe abortion care in Lusaka district struggled to use a preferred effective contraceptive method. This predisposed adolescents to subsequent unintended pregnancies after receiving a safe abortion service. Therefore, guidance on best practices in supporting teenagers prevent subsequent pregnancies including specific recommendations on providing contraception after abortion should be re-emphasized in primary health facilities in Zambia.
